Individual provider Active NPI

David T Magnesen, DPM

  • Podiatrist
  • St George, UT
National Provider Identifier
1699779066
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
370449-0501 Issued in UT
Practice address
676 S Bluff St Ste 205
St George, UT 84770-3568
Phone
(435) 628-5690
Fax
(435) 628-5805
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 9910 NV
Podiatrist 213E00000X 370449-0501 UT Primary

Addresses

Primary practice location

676 S Bluff St Ste 205
St George, UT 84770-3568

Mailing address

676 S Bluff St
Ste 205
St George, UT 84770-3568
Phone (435) 628-5690

Other practice location 1

700 Spring St
Caliente, NV 89008
Phone (435) 628-5690

Other identifiers 1

IdentifierTypeStateIssuer
002102792MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV, TX4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20050901000036 UT Practitioner - Podiatry 4284666090 Reassigns benefits to 1 organization
I20050912001068 NV Practitioner - Podiatry 4284666090 Reassigns benefits to 3 organizations
I20130708000577 TX Practitioner - Podiatry 4284666090 Reassigns benefits to 1 organization
O20100930017214 UT DME Supplier - Physician - PodiatryDME Supplier - Orthotic Personnel 9436270576 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: St George, UT

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William Bee Ririe HospitalGroup PAC ID 9335051747, 40 clinicians
Ely Shoshone TribeGroup PAC ID 1850491150, 2 clinicians
Scrodco PLLCGroup PAC ID 9436270576, 2 clinicians

Practice addresses (Care Compare)

1500 Ave H
Ely, NV 89301

1500 Ave H
Ely, NV 89301-2615
Phone (775) 289-3612

400 B Newe VW
Ely, NV 89301-3139
Phone (775) 289-2134

400 Newe View
Ely, NV 89301-3139

676 S Bluff St
St George, UT 84770-3568

700 N Spring St
Caliente, NV 89008-1010
Phone (435) 628-5690

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.38 of 100Reported as group
Quality
67.22
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
37.4 of 100Reported as group
Quality
27.48
Improvement activities
0
Cost
71.43

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue56
Removal of nail tissue1527
Removal or shaving of skin growth370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9910NVMDPodiatrist
370449-0501UTMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
William Bee Ririe Hospital CurrentSince Oct 30, 2010 Accepting new patients
William Bee Ririe Retail Pharmacy CurrentSince Oct 30, 2010 Accepting new patients
Scrodco PLLC Podiatrist CurrentSince May 30, 2000 Accepting new patients
Ely Shoshone Tribe PastSince Jan 19, 2020 Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients
Lincoln County Hospital District Past Accepting new patients

Locations

1500 Avenue H
Ely, NV 89301
Phone (775) 289-3001

6 Steptoe Cir
Ely, NV 89301
Phone (775) 289-3001

1299 Bertha Howe Ave
Mesquite, NV 89027
Phone (702) 345-4270

676 S Bluff St
Ste 205
St George, UT 84770
Phone (435) 628-5690

Interoperability endpoints

  • Direct secure messaging: magnesen@sfaa-ut.direct.office.nextgen.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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1699779066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 S BLUFF ST",
            "address_2": "STE 205",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703568",
            "telephone_number": "435-628-5690",
            "fax_number": "435-628-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 S BLUFF ST STE 205",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703568",
            "telephone_number": "435-628-5690",
            "fax_number": "435-628-5805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 SPRING ST",
            "address_purpose": "LOCATION",
            "city": "CALIENTE",
            "state": "NV",
            "postal_code": "89008",
            "country_code": "US",
            "telephone_number": "435-628-5690",
            "fax_number": "435-628-5805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAGNESEN",
        "first_name": "DAVID",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NV",
            "license": "9910",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "UT",
            "license": "370449-0501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002102792",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.