Provo Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PROVO SURGERY CENTER, LLC

Practice address

1157 N 300 W
Provo, UT 84604-6124

Phone

(385) 283-1906

NPI assigned

Jun 9, 2023

Organization subpart

No

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

Authorized official

Name

Adam Bergeson, MDNPI 1992970180

Title

Board Member

Phone

(801) 660-7980

Specialties & licenses 1

Addresses

Other names 2

• Intermountain Health Surgery Center - Utah Valley Doing business as
• Intermountain Surgery Center - Utah Valley Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Listed as

Provo Surgery Center LLCCCN 46C0001080

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Ihc Health Services Inc.

  • Emergency Medicine Physician
  • Huntsville, UT
  • NPI 1255465142

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adam Gary Bergeson, M.D.

  • Orthopaedic Surgery Physician
  • Provo, UT
  • NPI 1992970180
  NPD Authorized official

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764028800000",
    "number": "1639853757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 N 300 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 N 300 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046124",
            "telephone_number": "385-283-1906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVO SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-09",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A",
        "authorized_official_last_name": "BERGESON",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "801-660-7980",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Health Surgery Center - Utah Valley",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intermountain Surgery Center - Utah Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Provo Peak Chiropractic LLC
• Provo Pediatric Dental
• Provo Premier Dental Group PLLC
• Provo Psychological Solutions
• Provo Sports and Family Chiropractic, Inc.
• Provo Vision & Eye Care
• Cesar Prugue Chamorro
• Angela Jane Puertas
• Zachary John Pugh, MD
• Dylan Vaughn Pugmire

• Ambulatory Surgical Clinic/Center in Provo, UT
• Providers in Provo, UT by specialty
• Ambulatory Surgical Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; 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.