Individual provider Active NPI

Aaron Gregory Fausett, PA

  • Physician Assistant
  • Salem, UT
National Provider Identifier
1689854861
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7104965-1206 Issued in UT
Practice address
555 W State Road 164
Salem, UT 84653-5732
Phone
(801) 465-4896
Fax
(801) 465-3267
NPI assigned
Nov 6, 2007
Last updated
Aug 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7104965-1206 UT Primary

Addresses

Primary practice location

555 W State Road 164
Salem, UT 84653-5732

Mailing address

336 W 100 S
Spanish Fork, UT 84660-5881
Phone (801) 798-7301

Other identifiers 2

IdentifierTypeStateIssuer
315589OtherWYBCBS WY
125398100MedicaidWY

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130522000705 UT Practitioner - Physician Assistant 4183714850 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Canyon View Medical Group LLCGroup PAC ID 9739084351, 30 clinicians

Practice addresses (Care Compare)

325 W Ctr St
Spanish Fork, UT 84660-2060
Phone (801) 894-1333

591 N State Rd
198 Suite 202
Salem, UT 84653-5668
Phone (801) 465-9802

94 W Main St
Santaquin, UT 84655-5655
Phone (801) 754-3122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
7104965-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Apr 25, 2016 Accepting new patients
Canyon View Medical Group LLC CurrentSince Aug 1, 2023 Accepting new patients
Canyon View Medical Group LLC CurrentSince Aug 1, 2023 Accepting new patients
Revere Health PC CurrentSince Apr 25, 2016 Accepting new patients

Locations

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

555 W State Road 164
Salem, UT 84653
Phone (801) 465-4896

591 N State Road 198
Ste 203
Salem, UT 84653
Phone (801) 465-9802

94 W Main St
Santaquin, UT 84655
Phone (801) 754-3122

325 W Center St
Spanish Fork, UT 84660
Phone (801) 798-7301

336 W 100 S
Spanish Fork, UT 84660
Phone (385) 203-0246

55 E 400 N
Springville, UT 84663
Phone (801) 489-8464

Interoperability endpoints

  • Direct secure messaging: aaron.fausettpa.p1@direct.canyonviewmed.nextgenshare.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1689854861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 W 100 S",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846605881",
            "telephone_number": "801-798-7301",
            "fax_number": "801-798-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W STATE ROAD 164",
            "city": "SALEM",
            "state": "UT",
            "postal_code": "846535732",
            "telephone_number": "801-465-4896",
            "fax_number": "801-465-3267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUSETT",
        "first_name": "AARON",
        "middle_name": "GREGORY",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-06",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "7104965-1206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS WY",
            "identifier": "315589",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125398100",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, UT

Sources for this page

Verify at the official NPI Registry.