Individual provider Active NPI

Michael Arthur Hartman

  • Certified Registered Nurse Anesthetist
  • Vernal, UT
National Provider Identifier
1417075102
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
278512-8901 Issued in UT
Practice address
151 W 200 N
Vernal, UT 84078-1907
Phone
(435) 789-3352
Fax
(435) 781-6893
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 278512-8901 UT Primary

Addresses

Primary practice location

151 W 200 N
Vernal, UT 84078-1907

Mailing address

151 W 200 N
Vernal, UT 84078-1907
Phone (435) 789-3352

Other identifiers 1

IdentifierTypeStateIssuer
D6253MedicaidUT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120730000630 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961668322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashley Valley Physician Practice LLCGroup PAC ID 4284683947, 20 clinicians

Practice addresses (Care Compare)

150 W 100
Vernal, UT 84078-2036
Phone (435) 781-1200

Hospital & facility affiliations

  • Ashley Regional Medical Center Hospital, Vernal, UT, CCN 460030

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
278512-8901UTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ashley Valley Physician Practice LLC CurrentSince Sep 6, 2023 Accepting new patients
Ashley Valley Physician Practice, LLC CurrentSince Sep 6, 2023 Accepting new patients
Ashley Valley Physician Practice, LLC Past Accepting new patients

Locations

175 N 100 W
Ste 104
Vernal, UT 84078
Phone (435) 781-3053

150 W 100 N
Vernal, UT 84078
Phone (435) 789-3342

151 W 200 N
Vernal, UT 84078
Phone (435) 781-2650

Interoperability endpoints

  • Direct secure messaging: dya8583@yourcarecommunity.org

Organizations & group practices 3

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 1

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417075102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 W 200 N",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840781907",
            "telephone_number": "435-789-3352",
            "fax_number": "435-781-6893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 W 200 N",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840781907",
            "telephone_number": "435-789-3352",
            "fax_number": "435-781-6893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "MICHAEL",
        "middle_name": "ARTHUR",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "278512-8901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D6253",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernal, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.