Ethan J Erickson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

14194131-1205 Issued in UT

Practice address

2601 E Roosevelt St
Phoenix, AZ 85008-4973

Phone

(602) 344-5011

NPI assigned

Apr 5, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, ID2 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

Specialty

Emergency Medicine

Education

University of Texas Medical School at San Antonio, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minidoka Memorial Hospital 38 clinicians

Emergency Physicians Integrated Care LLC 203 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005
• Holy Cross Hospital-Davis Hospital, Layton, UT, CCN 460041
• Minidoka Memorial Hospital Hospital, Rupert, ID, CCN 131319

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Emergency Physicians Integrated Care, LLC

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1578598199

  Emergency Medicine, UT

  Medicare reassignment Care Compare group NPD
• Minidoka Memorial Hospital

  • Critical Access Hospital
  • Rupert, ID
  • NPI 1679553531

  ID

  Medicare reassignment Care Compare group NPD
• Minidoka Memorial Hospital

  • Rural Health Clinic/Center
  • Rupert, ID
  • NPI 1043387426
  Care Compare group NPD
• Gunnison Valley Hospital

  • Critical Access Hospital
  • Gunnison, UT
  • NPI 1952463036

  UT

  Medicare reassignment
• Minidoka Memorial Hospital

  • Skilled Nursing Facility
  • Rupert, ID
  • NPI 1023052040
  Care Compare group
• Minidoka Memorial Hospital

  • Emergency Care Clinic/Center
  • Rupert, ID
  • NPI 1134333495
  Care Compare group

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

• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Layton, UT
  • NPI 1346945839

  Hospital

  Care Compare affiliation
• Columbia Ogden Medical Center, Inc.

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1720031636

  Hospital

  Care Compare affiliation
• Minidoka Memorial Hospital

  • Critical Access Hospital
  • Rupert, ID
  • NPI 1679553531

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1689315426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 N 3RD ST STE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "602-344-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "ETHAN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "2271959",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "14194131-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa Erickson
• Cassandra Erickson, MS, LAT, ATC
• Claire Catherine Erickson
• Curtis Allen Erickson, M.D.
• Danae Raschelle Erickson, PA-C
• Jeffrey Todd Erickson, D.M.D.
• Jenna Rose Erickson, M.D.
• Jodi Erickson, LCSW
• Julie Erickson
• Kendall Bilger Erickson, P.T.

• All providers in Phoenix, AZ
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.

Verify at the official NPI Registry.