NPIMap

Organization Active NPI

Peak ENT Associates

Doing business as Thyroid Institute of Utah

  • Otolaryngology/Facial Plastic Surgery Physician
  • Provo, UT
National Provider Identifier
1346489036
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
Legal business name
PEAK ENT ASSOCIATES
Doing business as
Thyroid Institute of Utah
Practice address
1055 N 300 W
Suite 401
Provo, UT 84604-3344
Phone
(801) 357-7499
Fax
(801) 373-5980
NPI assigned
Feb 19, 2009
Last updated
Sep 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Tim Prusse
Title
Administrator
Phone
(801) 357-7499

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU
Otolaryngology Physician 207Y00000X NU
Otolaryngic Allergy Physician 207YX0602X NU
Otology & Neurotology Physician 207YX0901X NU
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X NU Primary
Audiologist 231H00000X NU

Addresses

Primary practice location

1055 N 300 W
Suite 401
Provo, UT 84604-3344

Mailing address

1055 N 300 W
Suite 401
Provo, UT 84604-3344
Phone (801) 357-7499

Other names 1

  • Thyroid Institute of Utah Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090402000646 UT Part B Supplier - Clinic/Group Practice 4284781543 Receives reassigned benefits from 47 practitioners
Practice locations: Lehi, UT; Nephi, UT; Provo, UT; Spanish Fork, UT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2064223Peak ENT Associates1055 N 300 W, Ste 401, Provo, UT 84604Certificate of waiverAug 14, 2027

National Provider Directory

National Provider Directory

Locations

3668 W 2150 N
Ste 300
Lehi, UT 84048

1055 N 300 W
Ste 311
Provo, UT 84604
Phone (385) 477-6800

692 E Market Place Dr
Ste 2
Spanish Fork, UT 84660

Practitioners & affiliated clinicians

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 51

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1346489036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 300 W",
            "address_2": "SUITE 401",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043344",
            "telephone_number": "801-357-7499",
            "fax_number": "801-373-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N 300 W",
            "address_2": "SUITE 401",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043344",
            "telephone_number": "801-357-7499",
            "fax_number": "801-373-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK ENT ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-19",
        "last_updated": "2025-09-02",
        "certification_date": "2025-07-17",
        "status": "A",
        "authorized_official_last_name": "PRUSSE",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "801-357-7499"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thyroid Institute of Utah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.