Luke Allan Counterman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12492705-1206 Issued in UT

Practice address

450 Williams Way
Moab, UT 84532-2185

Phone

(435) 719-3500

NPI assigned

Mar 24, 2021

Last updated

Nov 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, TX2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DHHS,PHS,Naihs, Gallup Indian Medical CenterGroup PAC ID 3173436409, 179 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Moab Regional Hospital Hospital, Moab, UT, CCN 461302
• Gallup Indian Medical Center Hospital, Gallup, NM, CCN 320061

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• DHHS,PHS,Naihs, Gallup Indian Medical Center

  • General Acute Care Hospital
  • Gallup, NM
  • NPI 1225002322

  TX

  Medicare reassignment Care Compare group NPD
• Moab Valley Healthcare, Inc

  dba Moab Regional Hospital

  • Critical Access Hospital
  • Moab, UT
  • NPI 1770513236
  Medicare reassignment
• Moab Valley Healthcare, Inc.

  dba Portal Pharmacy

  • Community/Retail Pharmacy
  • Moab, UT
  • NPI 1235918962
  NPD
• Moab Valley Healthcare, Inc.

  dba Moab Regional Recovery Center

  • Methadone Clinic
  • Moab, UT
  • NPI 1285380394
  NPD

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

• Moab Valley Healthcare, Inc

  dba Moab Regional Hospital

  • Critical Access Hospital
  • Moab, UT
  • NPI 1770513236
  Care Compare affiliation
• Moab Valley Healthcare, Inc.

  dba Moab Regional Recovery Center

  • Methadone Clinic
  • Moab, UT
  • NPI 1285380394

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1093391450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 BEHIND THE ROCKS DR",
            "city": "MOAB",
            "state": "UT",
            "postal_code": "845323917",
            "telephone_number": "616-265-2965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WILLIAMS WAY",
            "city": "MOAB",
            "state": "UT",
            "postal_code": "845322185",
            "telephone_number": "435-719-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUNTERMAN",
        "first_name": "LUKE",
        "middle_name": "ALLAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12492705-8906",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA59778",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12492705-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Jane Cook, M.D.
• William Cooper, M.AC.O.M., L.AC.
• Colleen Cornelius, DDS
• Jeffery Cornelius, DMD
• Kaylie Corrigan
• County of Grand
• Cindy L Cowan, SSW
• Rhonda Grace Cowern, DPT
• Meagan Elizabeth Coy
• Timothy Joseph Cristman, PA-C

• Physician Assistant in Moab, UT
• Providers in Moab, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.