Individual provider Active NPI

Brian Ebert, D.O.

  • Anesthesiology Physician
  • Lehi, UT
National Provider Identifier
1811307358
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
007568 Issued in AZ
Practice address
3340 N Center St Ste 800
Lehi, UT 84043-7406
Phone
(801) 990-1911
NPI assigned
May 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 12468911-1204 UT
Anesthesiology Physician 207L00000X 108448 MN
Anesthesiology Physician 207L00000X 59681 MN
Anesthesiology Physician 207L00000X 007568 AZ Primary

Addresses

Primary practice location

3340 N Center St Ste 800
Lehi, UT 84043-7406

Mailing address

3340 N Center St Ste 800
Lehi, UT 84043-7406
Phone (801) 990-1911

Other practice location 1

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 773-2505

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
I20220128000584 UT Practitioner - Anesthesiology 7810202876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Midwestern University, Chicago College of Osteopathic Med, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain West Anesthesia LLCGroup PAC ID 9032018502, 267 clinicians

Practice addresses (Care Compare)

1034 N 500
Provo, UT 84604-3380
Phone (801) 357-7850

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
89.3
Improvement activities
40
Cost
78.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12468911-1204UTMDAnesthesiology Physician
007568AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain West Anesthesia LLC Anesthesiology CurrentSince Nov 18, 2021 Accepting new patients

Locations

3340 N Center St
Ste 800
Lehi, UT 84043
Phone (800) 501-4788

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

150 W Civic Center Dr
Ste 200
Sandy, UT 84070
Phone (801) 727-2056

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 4

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": "1399334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1811307358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 N CENTER ST STE 800",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840437406",
            "telephone_number": "801-990-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 N CENTER ST STE 800",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840437406",
            "telephone_number": "801-990-1911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N Beaver St",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "86001",
            "country_code": "US",
            "telephone_number": "928-773-2505",
            "fax_number": "928-773-2504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBERT",
        "first_name": "BRIAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-06",
        "last_updated": "2022-09-01",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "12468911-1204",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "108448",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "59681",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "007568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehi, UT

Sources for this page

Verify at the official NPI Registry.