Individual provider Active NPI

Brandt L Esplin, MD

  • Hematology & Oncology Physician
  • Provo, UT
National Provider Identifier
1285929430
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
10204311-1205 Issued in UT
Practice address
1055 N 500 W Ste 202, BLDG C
Provo, UT 84604-8460
Phone
(801) 374-2367
Fax
(801) 374-2367
NPI assigned
Jun 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 10204311-1205 UT Primary

Addresses

Primary practice location

1055 N 500 W Ste 202, BLDG C
Provo, UT 84604-8460

Mailing address

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

Other practice location 1

96 E Kimballs Ln Ste 305
Draper, UT 84020-5021
Phone (801) 655-5670

Other identifiers 3

IdentifierTypeStateIssuer
P01167837OtherMNRAILROAD MEDICARE
ENROLLEDMedicaidIA
ENROLLEDMedicaidMN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address medreview@reverehealth.com Revere Health PC
Direct Messaging Address medreview@reverehealth.com Revere Health PC

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
I20170725003988 UT Practitioner - Hematology/Oncology 1557519980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
University of Oklahoma College of Medicine, 2011
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)

1055 N 500
Provo, UT 84604-3305
Phone (801) 429-8000

Hospital & facility affiliations

  • Intermountain Health Sevier Valley Hospital Hospital, Richfield, UT, CCN 460026
  • Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001
  • Castleview Hospital Hospital, Price, UT, CCN 460011
  • Uintah Basin Medical Center Hospital, Roosevelt, UT, CCN 460019
  • Intermountain Health Delta Community Hospital Hospital, Delta, UT, CCN 461300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10204311-1205UTMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Jul 31, 2017 Accepting new patients
Revere Health PC CurrentSince Jul 31, 2017 Accepting new patients

Locations

96 E Kimballs Ln
Ste 305
Draper, UT 84020
Phone (801) 655-5670

1020 S 1100 W
Ste B
Lehi, UT 84043
Phone (801) 653-2757

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

1055 N 500 W
Ste 202
Provo, UT 84604
Phone (801) 374-2367

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

Networks

  • UT PPO

Interoperability endpoints

  • Direct secure messaging: brandtesplin@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 9

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": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1285929430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W ATTN: CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "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": "1055 N 500 W STE 202, BLDG C",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846048460",
            "telephone_number": "801-374-2367",
            "fax_number": "801-374-2367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "96 E Kimballs Ln Ste 305",
            "address_purpose": "LOCATION",
            "city": "Draper",
            "state": "UT",
            "postal_code": "840205021",
            "country_code": "US",
            "telephone_number": "801-655-5670",
            "fax_number": "385-203-1344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESPLIN",
        "first_name": "BRANDT",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-16",
        "last_updated": "2023-11-27",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "UT",
            "license": "10204311-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01167837",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Revere Health PC",
            "address_1": "1055 N 500 W Ste 202, Bldg C",
            "city": "Provo",
            "state": "UT",
            "country_code": "US",
            "postal_code": "846048460",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Revere Health PC",
            "address_1": "96 E Kimballs Ln Ste 305",
            "city": "Draper",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840205021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.