Individual provider Active NPI

Abbie Ryan Sugihara, PA-C

  • Physician Assistant
  • Provo, UT
National Provider Identifier
1164079067
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8451587-1206 Issued in UT
Practice address
1034 N 500 W
Provo, UT 84604-3380
Phone
(801) 357-7850
NPI assigned
Aug 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8451587-1206 UT Primary

Addresses

Primary practice location

1034 N 500 W
Provo, UT 84604-3380

Mailing address

15219 S Cutlass CT
Bluffdale, UT 84065-2514

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221003002819 UT Practitioner - Physician Assistant 7911383666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1034 N 500
Provo, UT 84604-3380

400 C St
Salt Lake City, UT 84143-1005
Phone (801) 321-1123

8 TH Ave and C St
LDS Hosp Eeg Phys GRP
Salt Lake City, UT 84143
Phone (801) 507-7000

Hospital & facility affiliations

  • Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8451587-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Jun 26, 2022 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jun 26, 2022 Accepting new patients

Locations

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

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.

Hospital & facility affiliations 3

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": "1566691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1164079067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15219 S CUTLASS CT",
            "city": "BLUFFDALE",
            "state": "UT",
            "postal_code": "840652514"
        },
        {
            "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": "801-357-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUGIHARA",
        "first_name": "ABBIE",
        "middle_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-25",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8451587-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.