Individual provider Active NPI

Brent D. Mains

  • Physician Assistant
  • Alpine, UT
National Provider Identifier
1750079547
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14277457-1206 Issued in UT
Practice address
833 E Coventry LN
Alpine, UT 84004-1240
Phone
(385) 447-7929
NPI assigned
Apr 28, 2023
Last updated
Mar 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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 14277457-1206 UT Primary

Addresses

Primary practice location

833 E Coventry LN
Alpine, UT 84004-1240

Mailing address

833 E Coventry LN
Alpine, UT 84004-1240
Phone (385) 447-7929

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
I20260623004005 UT Practitioner - Physician Assistant 1153894936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Instant Orthopedic Specialists PLLCGroup PAC ID 4183199078, 2 clinicians

Practice addresses (Care Compare)

75 E 12300
Suite 100
Draper, UT 84020-8073
Phone (385) 386-7026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14277457-1206UTMDPhysician Assistant

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, 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": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1750079547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 E COVENTRY LN",
            "city": "ALPINE",
            "state": "UT",
            "postal_code": "840041240",
            "telephone_number": "385-447-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 E COVENTRY LN",
            "city": "ALPINE",
            "state": "UT",
            "postal_code": "840041240",
            "telephone_number": "385-447-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAINS",
        "first_name": "BRENT",
        "middle_name": "D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-28",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "14277457-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpine, UT

Sources for this page

Verify at the official NPI Registry.