Individual provider Active NPI

Preston Daniel Ward, MD

  • Facial Plastic Surgery Physician
  • Salt Lake City, UT
National Provider Identifier
1649396185
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
327556 Issued in UT
Practice address
6322 S 3000 E Ste 170
Salt Lake City, UT 84121-7290
Phone
(801) 739-3395
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 4301083582 MI
Pediatric Otolaryngology Physician 207YP0228X 4301083582 MI
Sleep Medicine (Otolaryngology) Physician 207YS0012X 4301083582 MI
Facial Plastic Surgery Physician 207YS0123X 4301083582 MI
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 327556 UT
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 4301083582 MI
Otolaryngic Allergy Physician 207YX0602X 4301083582 MI
Otology & Neurotology Physician 207YX0901X 4301083582 MI
Student in an Organized Health Care Education/Training Program 390200000X 4301083582 MI
Facial Plastic Surgery Physician 207YS0123X 327556 UT Primary
Otolaryngology Physician 207Y00000X 327556 UT

Addresses

Primary practice location

6322 S 3000 E Ste 170
Salt Lake City, UT 84121-7290

Mailing address

6322 S 3000 E Ste 170
Salt Lake City, UT 84121-7290
Phone (801) 739-3395

Other practice location 1

1500 E. Medical Center Drive
1st floor Taubman Ctr Recp A
Ann Arbor, MI 48109-5312
Phone (734) 936-8051

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
I20100630000349 UT Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 7012069586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
University of Utah School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6322 S 3000
Suite 170
Salt Lake City, UT 84121-7290
Phone (801) 513-3223

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
327556UTMDFacial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Form Surgery Center LLC Current Accepting new patients
Ward MD LLC Facial Plastic Surgery CurrentSince Feb 1, 2018 Accepting new patients

Locations

6322 S 3000 E
Ste 170
Salt Lake Cty, UT 84121
Phone (801) 513-3223

Organizations & group practices 2

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1649396185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6322 S 3000 E STE 170",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841217290",
            "telephone_number": "801-739-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6322 S 3000 E STE 170",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841217290",
            "telephone_number": "801-739-3395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E. Medical Center Drive",
            "address_2": "1st floor Taubman Ctr Recp A",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095312",
            "country_code": "US",
            "telephone_number": "734-936-8051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARD",
        "first_name": "PRESTON",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301083582",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "MI",
            "license": "4301083582",
            "primary": false
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "MI",
            "license": "4301083582",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "MI",
            "license": "4301083582",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "UT",
            "license": "327556",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "MI",
            "license": "4301083582",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "MI",
            "license": "4301083582",
            "primary": false
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "MI",
            "license": "4301083582",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301083582",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "UT",
            "license": "327556",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "UT",
            "license": "327556",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.