Individual provider Active NPI

Andrew Kenneth Ence, M.D.

  • Surgery of the Hand (Plastic Surgery) Physician
  • St George, UT
National Provider Identifier
1184072902
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery of the Hand (Plastic Surgery) PhysicianTaxonomy code 2082S0105X
License
12699267-1205 Issued in UT
Practice address
2825 E Mall Dr
St George, UT 84790-1954
Phone
(435) 628-9393
NPI assigned
Jun 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MMD.39395 LL SC
Orthopaedic Surgery Physician 207X00000X 0116034959 VA
Orthopaedic Surgery Physician 207X00000X 12699267-1205 UT
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X 12699267-1205 UT Primary

Addresses

Primary practice location

2825 E Mall Dr
St George, UT 84790-1954

Mailing address

1055 N 500 W
Attn Credentialing
Provo, UT 84604-3305
Phone (801) 354-8225

Other practice location 1

1930 W Sunset Blvd
St George, UT 84770-6587
Phone (435) 628-9393

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://uvahealth.com/locations/profile/hand-center
Direct Messaging Address medreview@reverehealth.com Central Utah Clinic, P.C.

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
I20220706003453 UT Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 9335429760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
University of Texas Medical School at San Antonio, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Revere Health PCGroup PAC ID 7517868508, 407 clinicians

Practice addresses (Care Compare)

2825 E Mall Dr
St George, UT 84790-1954
Phone (435) 673-6131

Hospital & facility affiliations

  • St. George Regional Hospital Hospital, St George, UT, CCN 460021

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)54
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MMD.39395 LLSCMDOrthopaedic Surgery Physician
0116034959VAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Aug 20, 2022 Accepting new patients
Revere Health PC CurrentSince Aug 20, 2022 Accepting new patients

Locations

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

1930 W Sunset Blvd
Ste 94
St George, UT 84770
Phone (435) 375-0140

2825 E Mall Dr
St George, UT 84790
Phone (435) 673-6131

Networks

  • UT PPO D-SNP
  • UT PPO

Interoperability endpoints

  • Direct secure messaging: andrewence@cuccu.allscriptsdirect.net

Organizations & group practices 2

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 1

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": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1184072902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "ATTN CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 E MALL DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847901954",
            "telephone_number": "435-628-9393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1930 W Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "St George",
            "state": "UT",
            "postal_code": "847706587",
            "country_code": "US",
            "telephone_number": "435-628-9393",
            "fax_number": "435-628-9382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENCE",
        "first_name": "ANDREW",
        "middle_name": "KENNETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-02",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SC",
            "license": "MMD.39395 LL",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0116034959",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "UT",
            "license": "12699267-1205",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "UT",
            "license": "12699267-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://uvahealth.com/locations/profile/hand-center",
            "affiliation": "N",
            "address_1": "415 Ray C Hunt Dr",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229032980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Central Utah Clinic, P.C.",
            "address_1": "2825 E Mall Dr",
            "city": "St George",
            "state": "UT",
            "country_code": "US",
            "postal_code": "847901954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.