Individual provider Active NPI

Andrew Benjamin Ward, PA

  • Physician Assistant
  • American Fork, UT
National Provider Identifier
1093138976
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8793861-1206 Issued in UT
Practice address
1184 E 80 N
American Fork, UT 84003-2906
Phone
(801) 763-3885
Fax
(801) 763-3887
NPI assigned
Jan 28, 2014
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 8793861-1206 UT
Physician Assistant 363A00000X 8793861-1206 UT Primary

Addresses

Primary practice location

1184 E 80 N
American Fork, UT 84003-2906

Mailing address

1055 N 500 W
Provo, UT 84604-3305
Phone (801) 812-4673

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140415001351 UT Practitioner - Physician Assistant 1557593092 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

3000 N Triumph Blvd
Lehi, UT 84043-7186

3336 S 4155
West Valley City, UT 84120

82 S 1100
Suite 103
Salt Lake City, UT 84102-1889
Phone (801) 505-5370

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8793861-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Jul 12, 2023 Accepting new patients
Physician Group of Utah Inc CurrentSince Apr 1, 2017 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Jul 12, 2023 Accepting new patients
Revere Health PC Past Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

3000 N Triumph Blvd
Ste 110
Lehi, UT 84043
Phone (385) 345-3555

3000 N Triumph Blvd
Ste 100
Lehi, UT 84043
Phone (385) 345-3155

82 S 1100 E
Ste 103
Salt Lake Cty, UT 84102
Phone (801) 505-5370

2530 W 4700 S
Ste B8
Taylorsville, UT 84129
Phone (801) 967-5866

3590 W 9000 S
Ste 240
West Jordan, UT 84088
Phone (801) 505-5370

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

Organizations & group practices 6

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 1

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": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1093138976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-812-4673",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1184 E 80 N",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032906",
            "telephone_number": "801-763-3885",
            "fax_number": "801-763-3887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "ANDREW",
        "middle_name": "BENJAMIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-28",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "8793861-1206",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8793861-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

Verify at the official NPI Registry.