Active NPI
Jake Anthony Lindberg Maranto
- Physician Assistant
- Provo, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 14226711-1206
- Practice address
- 395 W Cougar Blvd Ste 801
Provo, UT 84604-3311 - Phone
- (801) 229-1054
- NPI assigned
- May 10, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 14226711-1206 | UT | Primary |
Addresses
Primary practice location
395 W Cougar Blvd Ste 801
Provo, UT 84604-3311
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC/ Office Ally |
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, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1034 N 500
Provo, UT 84604-3380
Phone (801) 357-8879
395 W Bulldog Blvd
Provo, UT 84604-3323
5121 S Cottonwood St
Murray, UT 84107-5701
5131 S Cottonwood St
Murray, UT 84107-5701
Phone (801) 507-3888
700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600
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
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
395 W Cougar Blvd
Ste 801
Provo, UT 84604
Phone (801) 229-1054
1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479
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
-
- Family Medicine Physician
- Springville, UT
- NPI 1629104542
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
- Multi-Specialty Clinic/Center
- Orem, UT
- NPI 1588601124
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1746835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764547200000",
"number": "1144010380",
"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": "395 W COUGAR BLVD STE 801",
"city": "PROVO",
"state": "UT",
"postal_code": "846043311",
"telephone_number": "801-229-1054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARANTO",
"first_name": "JAKE",
"middle_name": "ANTHONY LINDBERG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-05-10",
"last_updated": "2025-12-01",
"certification_date": "2025-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "14226711-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.3",
"affiliationName": "Bluemark LLC/ Office Ally",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "1300 SE Cardinal Ct Ste 190",
"city": "Vancouver",
"state": "WA",
"country_code": "US",
"postal_code": "986839683",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.