Individual provider Active NPI

Andrew H Vaughan, MD

  • Otolaryngology Physician
  • St George, UT
National Provider Identifier
1164684643
Registry record updated Jun 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
7343869-1205 Issued in UT
Practice address
1490 E Foremaster Dr
Suite 350
St George, UT 84790-4488
Phone
(435) 628-3334
Fax
(435) 628-3375
NPI assigned
Jun 26, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0116016535 VA
Otolaryngology Physician 207Y00000X 7343869-1205 UT Primary

Addresses

Primary practice location

1490 E Foremaster Dr
Suite 350
St George, UT 84790-4488

Mailing address

1490 E Foremaster Dr
Suite 350
St George, UT 84790-4488
Phone (435) 628-3334

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090707000272 UT Practitioner - Otolaryngology 1456402353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Eastern Virginia Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Utah Ear Nose and Throat LLCGroup PAC ID 4082772777, 15 clinicians

Practice addresses (Care Compare)

617 E Riverside Dr
Suite 201
St George, UT 84790-8721
Phone (435) 628-3334

Hospital & facility affiliations

  • St. George Regional Hospital Hospital, St George, UT, CCN 460021
  • Kane County Hospital Hospital, Kanab, UT, CCN 461309
  • Intermountain Health Cedar City Hospital Hospital, Cedar City, UT, CCN 460007
  • Mesa View Regional Hospital Hospital, Mesquite, NV, CCN 291307

Merit-based Incentive Payment System (MIPS)

Final score
76.42 of 100Reported as group
Quality
65.48
Promoting interoperability
95
Improvement activities
40
Cost
60.1

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision13
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7343869-1205UTMDOtolaryngology Physician
0116016535VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Utah Ear Nose & Throat LLC Otolaryngology CurrentSince Jul 15, 2009 Accepting new patients

Locations

617 E Riverside Dr
Ste 201
St George, UT 84790
Phone (435) 628-3334

1490 E Foremaster Dr
Ste 350
St George, UT 84790
Phone (435) 251-5980

Organizations & group practices 1

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 5

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245283200000",
    "number": "1164684643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 E FOREMASTER DR",
            "address_2": "SUITE 350",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904488",
            "telephone_number": "435-628-3334",
            "fax_number": "435-628-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 E FOREMASTER DR",
            "address_2": "SUITE 350",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904488",
            "telephone_number": "435-628-3334",
            "fax_number": "435-628-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "ANDREW",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2009-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116016535",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "UT",
            "license": "7343869-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.