NPIMap

Individual provider Active NPI

Brian Jorgensen

  • Medical Physician Assistant
  • St George, UT
National Provider Identifier
1790187904
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
617 E Riverside Dr Ste 301
St George, UT 84790-8722
Phone
(435) 216-7000
Fax
(435) 216-7001
NPI assigned
Sep 18, 2014
Last updated
Mar 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

617 E Riverside Dr Ste 301
St George, UT 84790-8722

Mailing address

617 E Riverside Dr
Ste 301
St George, UT 84790-8722
Phone (435) 216-7000

Other practice location 1

340 Falcon Ridge Pkwy Ste 603
Mesquite, NV 89027-8852
Phone (702) 346-5037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, UT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141022000155 NV Practitioner - Physician Assistant 1951522630 Reassigns benefits to 1 organization
I20141027000976 UT Practitioner - Physician Assistant 1951522630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Desert Pain Specialists LLCGroup PAC ID 3072683051, 18 clinicians

Practice addresses (Care Compare)

340 Falcon Ridge Pkwy
Suite 603
Mesquite, NV 89027-8852
Phone (702) 346-5037

617 E Riverside Dr
St George, UT 84790-8722

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.53 of 100Reported as group
Quality
59.7
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Marchant Physical Therapy & Wellness, Inc. PastSince Aug 7, 2020 Accepting new patients
Southwest Skin and Cancer LLC Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1790187904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 E RIVERSIDE DR",
            "address_2": "STE 301",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847908722",
            "telephone_number": "435-216-7000",
            "fax_number": "435-216-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 E RIVERSIDE DR STE 301",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847908722",
            "telephone_number": "435-216-7000",
            "fax_number": "435-216-7001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 Falcon Ridge Pkwy Ste 603",
            "address_purpose": "LOCATION",
            "city": "Mesquite",
            "state": "NV",
            "postal_code": "890278852",
            "country_code": "US",
            "telephone_number": "702-346-5037",
            "fax_number": "702-346-5036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORGENSEN",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-18",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.