Individual provider Active NPI

Luke W Edelmayer, M.D.

  • Otolaryngology Physician
  • Ogden, UT
National Provider Identifier
1659723567
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
14195356-1205 Issued in UT
Practice address
4650 Harrison Blvd
Ogden, UT 84403-4303
Phone
(801) 475-3075
Fax
(801) 475-3076
NPI assigned
Jul 5, 2016
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 14195356-1205 UT Primary
Otology & Neurotology Physician 207YX0901X 14195356-1205 UT

Addresses

Primary practice location

4650 Harrison Blvd
Ogden, UT 84403-4303

Mailing address

PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220426003014 SC Practitioner - General Practice 2668768896 Reassigns benefits to 1 organization
I20250110001671 UT Practitioner - Otolaryngology 2668768896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Virginia Commonwealth University, School of Medicine, 2016
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)

4650 Harrison Blvd
Ogden, UT 84403-4303
Phone (801) 475-3482

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14195356-1205UTMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ogden Clinic Specialty Services LLC Otolaryngology CurrentSince Jan 8, 2025 Accepting new patients
Ogden Clinic PC Current Accepting new patients
Signify Health Medical Associates, PLLC General Practice CurrentSince Jan 1, 2022 Accepting new patients

Locations

2 Office Park Ct
Ste 103
Columbia, SC 29223
Phone (888) 721-0602

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

1041 S Medical Dr
Ste 202
Brigham City, UT 84302
Phone (385) 238-3375

970 Medical Dr
Ste 300
Brigham City, UT 84302

970 Medical Dr
Ste 309
Brigham City, UT 84302
Phone (385) 238-3375

4650 Harrison Blvd
Ogden, UT 84403
Phone (801) 475-3481

1491 E Ridgeline Dr
South Ogden, UT 84405
Phone (317) 790-7550

6112 S Harrison
South Ogden, UT 84405
Phone (801) 475-3800

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA
  • Direct secure messaging: ledelmayer144707@adventhealth.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1659723567",
    "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": "801-475-3500",
            "fax_number": "801-475-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844034303",
            "telephone_number": "801-475-3075",
            "fax_number": "801-475-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDELMAYER",
        "first_name": "LUKE",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-05",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "UT",
            "license": "14195356-1205",
            "primary": true
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "UT",
            "license": "14195356-1205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.