Active NPI
Mazen Sires, MD
- Hospitalist Physician
- Provo, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 6049611-1205
- Practice address
- 1034 N 500 W
Provo, UT 84604-3380 - Phone
- (801) 357-8310
- NPI assigned
- May 9, 2006
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 60496111205 | UT | |
| Hospitalist Physician | 208M00000X | 6049611-1205 | UT | Primary |
Addresses
Primary practice location
1034 N 500 W
Provo, UT 84604-3380
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00317619 | Other | UT | PALMETTO |
| 000059004 | Other | UT | MEDICARE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
170 N 1100
American Fork, UT 84003-2096
Phone (801) 357-7291
Hospital & facility affiliations
- Intermountain Health Utah Valley Hospital
- Castleview Hospital
- Intermountain Health Sevier Valley Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60496111205 | UT | MD | Internal Medicine Physician |
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 | Current | Accepting new patients |
Locations
170 N 1100 E
American Fork, UT 84003
Phone (801) 714-6570
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119
8th Ave And C St
Salt Lake City, UT 84143
Phone (801) 350-4110
5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998
9450 S 1300 E
Fl 4
Sandy, UT 84094
Phone (801) 501-2145
9660 S 1300 E
Sandy, UT 84094
Phone (801) 314-2417
5475 S 500 E
South Ogden, UT 84405
Phone (801) 479-2111
Organizations & group practices 3
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
-
- Pediatrics Physician
- St George, UT
- NPI 1922136126
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rural Acute Care Hospital
- Price, UT
- NPI 1417064205
-
- General Acute Care Hospital
- Provo, UT
- NPI 1114025491
-
- General Acute Care Hospital
- Richfield, UT
- NPI 1336256775
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681862400000",
"number": "1154370765",
"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",
"fax_number": "801-501-2188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1034 N 500 W",
"city": "PROVO",
"state": "UT",
"postal_code": "846043380",
"telephone_number": "801-357-8310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIRES",
"first_name": "MAZEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-09",
"last_updated": "2023-04-19",
"certification_date": "2023-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "UT",
"license": "60496111205",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "UT",
"license": "6049611-1205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO",
"identifier": "P00317619",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "000059004",
"state": "UT"
}
],
"endpoints": [],
"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 Apr 19, 2023; 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.