Revere Health PC
Organization Active NPI Orthopaedic Surgery Physician · Orem, UT
NPI 1780017954 · NPPES record last updated Jun 15, 2026
Key facts
- NPI
- 1780017954
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- REVERE HEALTH PC
- Practice address
- 700 W 800 N Ste 100
Orem, UT 84057-6302 - Phone
- (801) 373-7350
- Fax
- (801) 224-5337
- NPI assigned
- Aug 12, 2013
- Organization subpart
- No
Authorized official
- Name
- Elizabeth Hoyt
- Title
- Business Office Director
- Phone
- (801) 354-8225
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 10
Practitioners 407
-
Michael Max Adam, MD
-
Kaitlyn Miller Albrecht, MSN, RN, FNP-BC
-
Douglas A Allen, D.O.
-
Marvin R Allen, MD
-
Michael Anderson, M.D.
-
Nathan W Aston, PA-C
-
Darren H Averett, DPT
-
Justin Babbel, DO
-
Douglas K Bagley, PT
-
Tori Nicole Balser, FNP-C
-
Colby Lee Barber, M.D.
-
Collin C Barber, M.D.
-
Amber Dawn Barker, FNP
-
Dalton Thomas Barton, PA-C
-
Scott David Barton, M.D.
-
Lindsie Esme Bastian, PA-C
-
Russell J Beckstead, D.O.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 46D0973280 | Revere Health Orem Internal Medicine | Certificate of waiver | Apr 30, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Advanced Health Care of Salem |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (51%) Adp of the SNF |
Jan 25, 2016 Jun 10, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930033783 | UT | DME Supplier - Physician - Orthopedic/Orthopedic Surgery | 7517868508 | Practice locations: Orem, UT |
National Provider Directory
- Tax ID family
- Walstir H Fonseca MD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes |
Addresses
Primary practice location
700 W 800 N Ste 100
Orem, UT 84057-6302
Mailing address
1055 N 500 W
Attn: Credentialing
Provo, UT 84604-3305
Phone (801) 354-8225
Other names
- Revere Health
Other providers in Orem, UT
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- Restfully
- Restfully
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- Reynie Sandoval
- Elise Virginia Reynolds
- Kyle T Reynolds
All providers in Orem, UT · Orthopaedic Surgery Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.