Individual provider Active NPI

Tyson Jay Higgins, M.D.

  • Emergency Medicine Physician
  • Provo, UT
National Provider Identifier
1417319799
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
12115660-1205 Issued in UT
Practice address
1034 N 500 W
Provo, UT 84604-3380
Phone
(801) 357-7850
NPI assigned
Mar 24, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 19103 NV
Emergency Medicine Physician 207P00000X 12115660-1205 UT Primary

Addresses

Primary practice location

1034 N 500 W
Provo, UT 84604-3380

Mailing address

1777 E 1310 S
Spanish Fork, UT 84660-9261
Phone (801) 580-9533

Other practice location 1

1500 S Main St
Fort Worth, TX 76104-4917
Phone (817) 702-3431

Other practice location 2

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (702) 961-5000

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
I20210302001983 UT Practitioner - Emergency Medicine 4082909148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Valley Emergency Physicians IncGroup PAC ID 2860390879, 34 clinicians

Practice addresses (Care Compare)

331 N 400
Orem, UT 84057-1913
Phone (801) 224-4080

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19103NVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Valley Emergency Physicians Inc Emergency Medicine CurrentSince Feb 1, 2021 Accepting new patients

Locations

331 N 400 W
Orem, UT 84057
Phone (801) 224-4080

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

Organizations & group practices 1

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 5

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": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1417319799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 E 1310 S",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846609261",
            "telephone_number": "801-580-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043380",
            "telephone_number": "801-357-7850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044917",
            "country_code": "US",
            "telephone_number": "817-702-3431",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3186 S Maryland Pkwy",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891092317",
            "country_code": "US",
            "telephone_number": "702-961-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIGGINS",
        "first_name": "TYSON",
        "middle_name": "JAY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-24",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "19103",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "12115660-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.