Alex Garrett Ertl, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

10039833-2504 Issued in UT

Practice address

248 E 13800 S
#4
Draper, UT 84020-5010

Phone

(801) 816-1801

Fax

(801) 501-0249

NPI assigned

Oct 4, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2025 through Jan 1, 2027

Merit-based Incentive Payment System (MIPS)

Final score

89.69 of 100Reported as group

Quality

89.02

Promoting interoperability

85

Improvement activities

40

Cost

55.8

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Corner Canyon Counseling

  • Community/Behavioral Health Agency
  • Draper, UT
  • NPI 1114371580
  NPD (past)

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1386194280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 E 13800 S",
            "address_2": "#4",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205010",
            "telephone_number": "801-816-1801",
            "fax_number": "801-501-0249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 E 13800 S",
            "address_2": "#4",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205010",
            "telephone_number": "801-816-1801",
            "fax_number": "801-501-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERTL",
        "first_name": "ALEX",
        "middle_name": "GARRETT",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-04",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "10039833-2504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gentrey Erickson
• Mandy Erickson, LCMHC
• Mariah Erickson
• Michael Erickson
• Maren Maurine Ernstrom, CMHC
• Guillermina Elizabeth Escareno
• Katie Esch
• Triston Glenn Eschweiler
• Abigail Escobar
• Brigitte Rose Espenschied

• Psychologist in Draper, UT
• Providers in Draper, UT by specialty
• Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• 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.