Individual provider Active NPI

Justyna O'Conor, MD

  • Cardiovascular Disease Physician
  • Ogden, UT
National Provider Identifier
1285124784
Registry record updated Nov 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
13882223-1205 Issued in UT
Practice address
4403 Harrison Blvd Ste 3490
Ogden, UT 84403-3284
Phone
(801) 387-2650
NPI assigned
May 10, 2018
Last updated
Nov 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2025

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 NU
Cardiovascular Disease Physician 207RC0000X 13882223-1205 UT Primary

Addresses

Primary practice location

4403 Harrison Blvd Ste 3490
Ogden, UT 84403-3284

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

1055 N 500 W Ste 101
Provo, UT 84604-3305
Phone (801) 373-4366

Other practice location 2

1175 E 50 S Ste 251
American Fork, UT 84003-2850
Phone (801) 492-2815

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

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
I20240705003167 UT Practitioner - Cardiovascular Disease (Cardiology) 0547508012 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Georgetown University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians
Revere Health PCGroup PAC ID 7517868508, 407 clinicians

Practice addresses (Care Compare)

1034 N 500
Provo, UT 84604-3380
Phone (801) 357-4423

1055 N 500
Provo, UT 84604-3305
Phone (801) 373-4366

201 W Layton Pkwy
Suite 2a
Layton, UT 84041-3692
Phone (801) 543-6825

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Nov 28, 2024 Accepting new patients
Revere Health PC CurrentSince Jul 1, 2024 Accepting new patients
Ihc Health Services Inc CurrentSince Nov 28, 2024 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Sep 14, 2025 Accepting new patients
Revere Health PC CurrentSince Jul 1, 2024 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

1175 E 50 S
Ste 251
American Fork, UT 84003
Phone (801) 492-2815

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

201 W Layton Pkwy
Ste 2A
Layton, UT 84041
Phone (801) 387-7185

4403 Harrison Blvd
Ste 3400
Ogden, UT 84403
Phone (801) 387-3400

4403 Harrison Blvd
Ste 3490
Ogden, UT 84403
Phone (801) 387-2650

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

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

1055 N 500 W
Ste 101
Provo, UT 84604

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

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764288000000",
    "number": "1285124784",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD STE 3490",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033284",
            "telephone_number": "801-387-2650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1055 N 500 W Ste 101",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846043305",
            "country_code": "US",
            "telephone_number": "801-373-4366",
            "fax_number": "801-429-8191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1175 E 50 S Ste 251",
            "address_purpose": "LOCATION",
            "city": "American Fork",
            "state": "UT",
            "postal_code": "840032850",
            "country_code": "US",
            "telephone_number": "801-492-2815",
            "fax_number": "801-492-0191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'CONOR",
        "first_name": "JUSTYNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-10",
        "last_updated": "2025-11-28",
        "certification_date": "2025-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "UT",
            "license": "13882223-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.