Individual provider Active NPI

Ilsley Ben Colton, MD

  • Family Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1063943116
Registry record updated Jan 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12229251-1205 Issued in UT
Practice address
1409 E Bryan Ave
Salt Lake City, UT 84105-2651
Phone
(802) 922-0872
NPI assigned
Mar 21, 2017
Last updated
Jan 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 12229251-1205 UT Primary

Addresses

Primary practice location

1409 E Bryan Ave
Salt Lake City, UT 84105-2651

Mailing address

1409 E Bryan Ave
Salt Lake City, UT 84105-2651
Phone (802) 922-0872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210510002547 UT Practitioner - Family Practice 9234400177 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Vermont College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Regional Hospitalists LLCGroup PAC ID 4789807165, 119 clinicians

Practice addresses (Care Compare)

1200 E 3900
Salt Lake City, UT 84124-1300
Phone (801) 783-5011

3000 N Triumph Blvd
Lehi, UT 84043-4999
Phone (801) 783-5011

3460 S Pioneer Pkwy
West Valley, UT 84120-2049
Phone (801) 783-5011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.89 of 100Reported as group
Quality
100
Improvement activities
40
Cost
66.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12229251-1205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Togo Acute and Post Acute Care Family Medicine CurrentSince Sep 10, 2023 Accepting new patients
Grab Healthcare, LLC Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Utah Regional Hospitalists LLC CurrentSince Apr 3, 2021 Accepting new patients
Utah Regional Hospitalists LLC CurrentSince Apr 3, 2021 Accepting new patients

Locations

406 W South Jordan Pkwy
Ste 450
South Jordan, UT 84095
Phone (801) 561-8398

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 562-4210

Interoperability endpoints

  • Direct secure messaging: icolton106813@direct.uvmhealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705190400000",
    "number": "1063943116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 E BRYAN AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841052651",
            "telephone_number": "802-922-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 E BRYAN AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841052651",
            "telephone_number": "802-922-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLTON",
        "first_name": "ILSLEY",
        "middle_name": "BEN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2024-01-14",
        "certification_date": "2024-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "12229251-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.