Individual provider Active NPI

Robert William Apps Ross, PA

  • Physician Assistant
  • Provo, UT
National Provider Identifier
1528731809
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12458183-1206 Issued in UT
Practice address
395 W Cougar Blvd Ste 205
Provo, UT 84604-3328
Phone
(801) 357-1770
Fax
(801) 357-1779
NPI assigned
Aug 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12458183-1206 UT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

395 W Cougar Blvd Ste 205
Provo, UT 84604-3328

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

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
I20220117000063 UT Practitioner - Physician Assistant 7911399332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

3249 N 1200
Lehi, UT 84043-9772
Phone (801) 753-4300

354 W Crossroads Blvd
Saratoga Springs, UT 84045-5506
Phone (801) 341-5295

354 W State Rd
Suite 73
Saratoga Springs, UT 84045-5506
Phone (801) 341-5200

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

98 N 1100
American Fork, UT 84003-2940

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12458183-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Oct 13, 2021 Accepting new patients
Ihc Health Services, Inc. CurrentSince Oct 13, 2021 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

395 W Cougar Blvd
Ste 205
Provo, UT 84604
Phone (801) 357-1770

395 W Cougar Blvd
Provo, UT 84604
Phone (801) 357-4141

354 W State Road 73
Saratoga Springs, UT 84045
Phone (801) 341-5200

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.

NPI Registry JSON

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

{
    "created_epoch": "1627776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1528731809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W COUGAR BLVD STE 205",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043328",
            "telephone_number": "801-357-1770",
            "fax_number": "801-357-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "ROBERT",
        "middle_name": "WILLIAM APPS",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-01",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12458183-1206",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.