Individual provider Active NPI

Ashley Lynne Cardenas, PA-C

  • Physician Assistant
  • Provo, UT
National Provider Identifier
1205481801
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11856778-1206 Issued in UT
Practice address
1034 N 500 W
Provo, UT 84604-3337
Phone
(801) 357-7850
NPI assigned
Aug 9, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA195066 OR
Physician Assistant 363A00000X 11856778-1206 UT Primary

Addresses

Primary practice location

1034 N 500 W
Provo, UT 84604-3337

Mailing address

1034 N 500 W
Provo, UT 84604-3337

Other identifiers 3

IdentifierTypeStateIssuer
1162379OtherNATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS
11856778-1206OtherUTUTAH MEDICAL BOARD
PA195066OtherOROREGON MEDICAL BOARD

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
I20220516001703 UT Practitioner - Physician Assistant 8123451101 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
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
Phone (801) 357-8879

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA195066ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Mar 31, 2024 Accepting new patients
Ihc Health Services, Inc. CurrentSince Mar 31, 2024 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

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

Organizations & group practices 4

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 4

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": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1205481801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043337"
        },
        {
            "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": "846043337",
            "telephone_number": "801-357-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDENAS",
        "first_name": "ASHLEY",
        "middle_name": "LYNNE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-09",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA195066",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "11856778-1206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS",
            "identifier": "1162379",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTAH MEDICAL BOARD",
            "identifier": "11856778-1206",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON MEDICAL BOARD",
            "identifier": "PA195066",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.