Active NPI
Ethan Michael Young, PA
- Physician Assistant
- Riverton, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 12384125-1206
- Practice address
- 3723 W 12600 S Ste 430
Riverton, UT 84065-7310 - Phone
- (801) 285-4200
- NPI assigned
- Dec 30, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 12384125-1206 | UT | Primary |
| Medical Physician Assistant | 363AM0700X |
Addresses
Primary practice location
3723 W 12600 S Ste 430
Riverton, UT 84065-7310
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 706-1152
Other practice location 1
7170 Smoke Ranch Rd Ste 110
Las Vegas, NV 89128-3569
Phone (702) 463-3333
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1034 N 500
Provo, UT 84604-3380
Phone (801) 357-8879
395 W Bulldog Blvd
Provo, UT 84604-3311
700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600
765 E Marker Place Dr
Spanish Fork, UT 84660-1396
Phone (385) 344-5651
819 E Market Place Dr
Spanish Fork, UT 84660-1396
Phone (801) 357-7420
Hospital & facility affiliations
- Intermountain Health Utah Valley Hospital
- Intermountain Health Spanish Fork Hospital
- Intermountain Health Sanpete Valley Hospital
- American Fork Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Past | Accepting new patients |
Locations
98 N 1100 E
Ste 302
American Fork, UT 84003
Phone (801) 357-7081
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
395 W Cougar Blvd
Provo, UT 84604
Phone (801) 357-4141
395 W Cougar Blvd
Ste 503
Provo, UT 84604
Phone (801) 357-4600
3723 W 12600 S
Ste 430
Riverton, UT 84065
Phone (801) 285-4200
819 E Market Place Dr
Spanish Fork, UT 84660
Phone (385) 344-6600
819 E Market Place Dr
Ste 2C
Spanish Fork, UT 84660
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.
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1942325154
-
- Urgent Care Clinic/Center
- Spanish Fork, UT
- NPI 1730215518
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
- Multi-Specialty Clinic/Center
- Orem, UT
- NPI 1588601124
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Provo, UT
- NPI 1114025491
-
- General Acute Care Hospital
- Spanish Fork, UT
- NPI 1124661384
-
- Critical Access Hospital
- Mt Pleasant, UT
- NPI 1407964398
-
- General Acute Care Hospital
- American Fork, UT
- NPI 1912014358
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649721600000",
"number": "1124590229",
"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",
"telephone_number": "801-706-1152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3723 W 12600 S STE 430",
"city": "RIVERTON",
"state": "UT",
"postal_code": "840657310",
"telephone_number": "801-285-4200"
}
],
"practiceLocations": [
{
"address_1": "7170 Smoke Ranch Rd Ste 110",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891283569",
"country_code": "US",
"telephone_number": "702-463-3333",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YOUNG",
"first_name": "ETHAN",
"middle_name": "MICHAEL",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-30",
"last_updated": "2022-04-12",
"certification_date": "2022-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "12384125-1206",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Riverton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.