Individual provider Active NPI

Jeffrey David Sparenborg, M.D.

  • Urology Physician
  • Provo, UT
National Provider Identifier
1104182476
Registry record updated Jul 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
10386883-1205 Issued in UT
Practice address
1157 N 300 W Ste 301
Provo, UT 84604-6124
Phone
(801) 357-7009
Fax
(801) 357-8132
NPI assigned
Apr 11, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 10386883-1205 UT Primary

Addresses

Primary practice location

1157 N 300 W Ste 301
Provo, UT 84604-6124

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

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
I20170728003250 UT Practitioner - Urology 2769753482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1034 N 500
Provo, UT 84604-3380
Phone (801) 357-8879

395 W Bulldog Blvd
Provo, UT 84604-3333

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

750 W 800
Orem, UT 84057-3660
Phone (801) 714-6000

Hospital & facility affiliations

  • Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001
  • Timpanogos Regional Hospital Hospital, Orem, UT, CCN 460052
  • Intermountain Health Sanpete Valley Hospital Hospital, Mount Pleasant, UT, CCN 461303
  • American Fork Hospital Hospital, American Fork, UT, CCN 460023
  • Intermountain Health Spanish Fork Hospital Hospital, Spanish Fork, UT, CCN 460062

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection88

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Ihc Health Services Inc CurrentSince Jul 1, 2017 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

395 W Cougar Blvd
Ste 704
Provo, UT 84604
Phone (801) 357-3242

1157 N 300 W
Ste 301
Provo, UT 84604
Phone (801) 357-1200

819 E Market Place Dr
Spanish Fork, UT 84660
Phone (385) 344-6600

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499472000000",
    "number": "1104182476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 N 300 W STE 301",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046124",
            "telephone_number": "801-357-7009",
            "fax_number": "801-357-8132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARENBORG",
        "first_name": "JEFFREY",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2017-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "UT",
            "license": "10386883-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.