Individual provider Active NPI

Ryan Busch

  • Physician Assistant
  • Pleasant Grove, UT
National Provider Identifier
1831590504
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12315115-1206 Issued in UT
Practice address
35 S 1200 W
Pleasant Grove, UT 84062-2984
Phone
(916) 208-6295
NPI assigned
Sep 11, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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 12315115-1206 UT Primary

Addresses

Primary practice location

35 S 1200 W
Pleasant Grove, UT 84062-2984

Mailing address

35 S 1200 W
Pleasant Grove, UT 84062-2984
Phone (916) 208-6295

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
I20240712001062 UT Practitioner - Physician Assistant 9133664279 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Family MedicalGroup PAC ID 7416197785, 84 clinicians

Practice addresses (Care Compare)

275 W 200
Lindon, UT 84042-5009
Phone (801) 796-1333

680 E Main St
Lehi, UT 84043-2241
Phone (801) 768-1699

830 N 2000
Pleasant Grove, UT 84062-4047
Phone (801) 756-3511

Hospital & facility affiliations

  • Holy Cross Hospital-Jordan Valley Hospital, West Jordan, UT, CCN 460051

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Family Medical - Saratoga Springs CurrentSince Jul 1, 2024 Accepting new patients
Ma Bo Inc CurrentSince Mar 4, 2026 Accepting new patients
Premier Family Medical - City Center CurrentSince Jul 1, 2024 Accepting new patients
Premier Family Medical Past Accepting new patients

Locations

226 N 1100 E
American Fork, UT 84003
Phone (801) 855-3840

3943 E Pony Express Pkwy
Ste 120
Eagle Mountain, UT 84005
Phone (801) 443-1184

3000 N Triumph Blvd
Ste 220
Lehi, UT 84043
Phone (801) 642-2990

680 E Main St
Lehi, UT 84043
Phone (801) 766-0606

275 W 200 N
Lindon, UT 84042
Phone (801) 796-1333

830 N 2000 W
Pleasant Grv, UT 84062
Phone (801) 756-3511

466 E 500 S
Ste 200
Salt Lake Cty, UT 84111
Phone (801) 485-5055

62 E Thrive Dr
Ste 100
Saratoga Springs, UT 84045
Phone (801) 766-8427

707 E Mill Rd
Ste 303
Vineyard, UT 84059
Phone (801) 224-1300

Organizations & group practices 6

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 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": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1831590504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 S 1200 W",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840622984",
            "telephone_number": "916-208-6295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 S 1200 W",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840622984",
            "telephone_number": "916-208-6295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSCH",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-11",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12315115-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Grove, UT

Sources for this page

Verify at the official NPI Registry.