Individual provider Active NPI

Christopher Lloyd Berentzen, M.D.

  • Anesthesiology Physician
  • Logan, UT
National Provider Identifier
1699917831
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
7771252-1205 Issued in UT
Practice address
1400 N 500 E
Logan, UT 84341-2455
NPI assigned
Apr 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 7771252-1205 UT Primary

Addresses

Primary practice location

1400 N 500 E
Logan, UT 84341-2455

Mailing address

560 W 465 N Ste 604
Providence, UT 84332-8006
Phone (435) 753-1600

Other practice location 1

560 W 465 N Ste 604
Providence, UT 84332-8006
Phone (435) 753-1600

Other identifiers 1

IdentifierTypeStateIssuer
1699917831MedicaidUT

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141028003097 UT Practitioner - Anesthesiology 9931342508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical College of Wisconsin, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interwest Anesthesia Associates LLCGroup PAC ID 0042293359, 29 clinicians

Practice addresses (Care Compare)

2380 N 400
North Logan, UT 84341-6000
Phone (435) 713-9700

55 E Golf Course Rd
Logan, UT 84321-0001
Phone (435) 760-3734

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7771252-1205UTMDAnesthesiology Physician

Organizations & group practices 1

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": "1238630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1699917831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W 465 N STE 604",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843328006",
            "telephone_number": "435-753-1600",
            "fax_number": "435-753-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N 500 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "560 W 465 N Ste 604",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "UT",
            "postal_code": "843328006",
            "country_code": "US",
            "telephone_number": "435-753-1600",
            "fax_number": "435-753-9521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERENTZEN",
        "first_name": "CHRISTOPHER",
        "middle_name": "LLOYD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-02",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "7771252-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699917831",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

Verify at the official NPI Registry.