Active NPI
Luke W Edelmayer, M.D.
- Otolaryngology Physician
- Ogden, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 14195356-1205
- 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, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
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
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 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14195356-1205 | UT | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ogden Clinic Specialty Services LLC | Otolaryngology | Current | Accepting new patients |
| Ogden Clinic PC | Current | Accepting new patients | |
| Signify Health Medical Associates, PLLC | General Practice | Current | 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
- https://fhir4.healow.com/fhir/r4/JJJGBA
- 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.
-
dba Ogden Clinic PC
- Sports Medicine (Family Medicine) Physician
- Ogden, UT
- NPI 1114203668
Otolaryngology
-
- Family Medicine Physician
- Ogden, UT
- NPI 1578550083
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Ogden Regional Medical Center
- General Acute Care Hospital
- Ogden, UT
- NPI 1720031636
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.