Gabriel James Sermon, PA-C
Individual provider Active NPI Medical Physician Assistant · Draper, UT
NPI 1639299282 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1639299282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 379294-1206 (UT)
- Practice address
- 212 E 12300 S
Draper, UT 84020-8184 - Phone
- (801) 571-4666
- NPI assigned
- Mar 29, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Castleview Hospital LLC
Practice addresses (Care Compare)
90 W Main St
Castledale, UT 84513-0607
Phone (435) 381-2305
Hospital & facility affiliations
- Symbii Home Health South
- Castleview Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070625000411 | UT | Practitioner - Physician Assistant | 0749389245 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Castleview Physician Practice, LLC | Current |
Accepting new patients | |
| Castleview Hospital, LLC | Current |
Accepting new patients | |
| Castleview Physician Practice, LLC | Current |
Accepting new patients |
Locations
300 N Hospital Dr
Price, UT 84501
Phone (435) 636-4836
945 W Hospital Dr
Ste 1
Price, UT 84501
Phone (435) 637-4327
317 E 100 N
Ste 4
Price, UT 84501
Phone (435) 637-6337
Interoperability endpoints
- gabriel.sermon.1@19848.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 379294-1206 | UT | Yes |
Addresses
Primary practice location
212 E 12300 S
Draper, UT 84020-8184
Mailing address
306 E 160 N
American Fork, UT 84003-1779
Other providers in Draper, UT
- Nicole Sebaske
- Yvette Segovia
- Patricia Segui
- Emily Anne Sellers
- Sequoia Wellness LLC
- Tracey Sermon
- Emily Setser
- Seida Severiano-Campos
- Sevocation Anesthesia, PLLC
- Amanda Seymour
All providers in Draper, UT · Medical Physician Assistant in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.