Individual provider Active NPI

Joshuah Ivan Anderson, PA-S

  • Physician Assistant
  • Orem, UT
National Provider Identifier
1396428348
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
800 W University Pkwy
Orem, UT 84058-6703
Phone
(801) 863-8000
NPI assigned
Aug 8, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

800 W University Pkwy
Orem, UT 84058-6703

Mailing address

800 W University Pkwy
Orem, UT 84058-6703
Phone (801) 863-8000

Other practice location 1

154 E 1200 S
Centerville, UT 84014-2247
Phone (801) 946-9080

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
I20241218004062 UT Practitioner - Physician Assistant 4082141767 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midtown Community Health Center IncGroup PAC ID 0345135414, 26 clinicians

Practice addresses (Care Compare)

22 S State St
Clearfield, UT 84015-1043
Phone (801) 334-0030

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Midtown Community Health Center Inc CurrentSince Dec 26, 2024 Accepting new patients
Midtown Community Health Center Inc CurrentSince Dec 26, 2024 Accepting new patients
Midtown Community Health Center Inc Past Accepting new patients
Midtown Community Health Center Inc Past Accepting new patients
Ihc Health Services, Inc. PastSince Jan 14, 2024 Accepting new patients

Locations

22 S State St
Clearfield, UT 84015
Phone (801) 525-5000

22 S State St
Ste 1007
Clearfield, UT 84015
Phone (801) 334-0030

2240 Adams Ave
Ogden, UT 84401
Phone (801) 393-5355

60 E 3750 S
South Salt Lake, UT 84115
Phone (801) 262-3315

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1396428348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W UNIVERSITY PKWY",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840586703",
            "telephone_number": "801-863-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W UNIVERSITY PKWY",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840586703",
            "telephone_number": "801-863-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "154 E 1200 S",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "UT",
            "postal_code": "840142247",
            "country_code": "US",
            "telephone_number": "801-946-9080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JOSHUAH",
        "middle_name": "IVAN",
        "credential": "PA-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-08",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

Verify at the official NPI Registry.