Peter Gibbs Ventura, MD
Individual provider Active NPI Otolaryngology Physician · Tooele, UT
NPI 1144201690 · NPPES record last updated Feb 10, 2016
Key facts
- NPI
- 1144201690
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Otolaryngology Physician 207Y00000X
- License
- 58686931205 (UT)
- Practice address
- 2376 N 400 E
Ste 202
Tooele, UT 84074-3413 - Phone
- (435) 833-9600
- NPI assigned
- Nov 10, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050802000261 | UT | Practitioner - Otolaryngology | 9234123449 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58686931205 | UT | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| ENT Surgical Associates PC | Otolaryngology | Current |
Accepting new patients |
| ENT Surgical Associates PC | Otolaryngology | Current | Accepting new patients |
| Cornerstone Medical Assoc., LLC | Past | Accepting new patients | |
| Personal Recovery Network LLC | Past |
Accepting new patients |
Locations
2376 N 400 E
Ste 202
Tooele, UT 84074
Phone (435) 833-9600
Interoperability endpoints
- pventura@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 58686931205 | UT | Yes |
Addresses
Primary practice location
2376 N 400 E
Ste 202
Tooele, UT 84074-3413
Mailing address
2376 N 400 E
Ste 202
Tooele, UT 84074-3413
Phone (435) 833-9600
Other providers in Tooele, UT
- Erika Valdez
- Daniela Valerio
- Valley Family Medicine PC
- Valley Mental Health Incorporated
- Valley West Health
- Clair Reed Vernon
- Heidi Vernon
- Igor Vidovic
- Matthew Vincent
- Samantha Marie Vincent
All providers in Tooele, UT · Otolaryngology Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.