Todd Dale Lythgoe, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8092052-1206 Issued in UT

Practice address

1560 Renaissance Towne Dr
Suite 210
Bountiful, UT 84010-7680

Phone

(801) 397-6100

Fax

(801) 397-6101

NPI assigned

Jul 18, 2006

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

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

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ogden Clinic Specialty Services LLCGroup PAC ID 1658781422, 131 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Ogden Clinic Specialty Services LLC

  • Sports Medicine (Family Medicine) Physician
  • Ogden, UT
  • NPI 1114203668
  Medicare reassignment Care Compare group
• Wasatch Dermatology, PC

  • Dermatology Physician
  • Ogden, UT
  • NPI 1891176939
  Medicare reassignment

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1477571065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-397-6100",
            "fax_number": "801-397-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 RENAISSANCE TOWNE DR",
            "address_2": "SUITE 210",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107680",
            "telephone_number": "801-397-6100",
            "fax_number": "801-397-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYTHGOE",
        "first_name": "TODD",
        "middle_name": "DALE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8092052-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karina Sofia Luna
• Heidee Lynn Lund, M.D.
• Clarke Lunt
• John B Lyman, MD
• Ryan Thomas Lythgoe
• Bethany Mack
• Matthew Hubbard Mackay, D.D.S.
• Elisa Madison
• Cristina Thalia Magallanes
• Cambria Maisey

• Physician Assistant in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.