Organization Active NPI

Ear, Nose & Throat Surgery Center of Utah LLC

Doing business as Intermountain Health Surgery Center - Alta View

  • Ambulatory Surgical Clinic/Center
  • Sandy, UT
National Provider Identifier
1790906204
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
EAR, NOSE & THROAT SURGERY CENTER OF UTAH LLC
Doing business as
Intermountain Health Surgery Center - Alta View
Intermountain Surgery Center - Alta View
Practice address
9450 S 1300 E Ste 100
Sandy, UT 84094-5555
Phone
(801) 924-2878
Fax
(801) 924-2888
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Authorized official

Name
Jeremy Peters
Title
VP Strategic Partnership
Phone
(303) 813-5160

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

9450 S 1300 E Ste 100
Sandy, UT 84094-5555

Mailing address

9450 S 1300 E Ste 100
Sandy, UT 84094-5555
Phone (801) 924-2878

Other names 2

  • Intermountain Health Surgery Center - Alta View Doing business as
  • Intermountain Surgery Center - Alta View Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050823000175 UT Part B Supplier - Ambulatory Surgical Center 5092746784 Practice locations: Sandy, UT

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Ear Nose and Throat Surgery Center of Utah LLCCCN 46C0001041
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2308710Intermountain Surgery Center - Alta View9450 South 1300 East, Suite 100, Sandy, UT 84094Certificate of waiverJul 31, 2026

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

22 S 900 E
Ste 2
Salt Lake City, UT 84102

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764028800000",
    "number": "1790906204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9450 S 1300 E STE 100",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840945555",
            "telephone_number": "801-924-2878",
            "fax_number": "801-924-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9450 S 1300 E STE 100",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840945555",
            "telephone_number": "801-924-2878",
            "fax_number": "801-924-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR, NOSE & THROAT SURGERY CENTER OF UTAH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "VP STRATEGIC PARTNERSHIP",
        "authorized_official_telephone_number": "303-813-5160"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Health Surgery Center - Alta View",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intermountain Surgery Center - Alta View",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.