Andrew Stevens, DO
Individual provider Active NPI Surgery Physician · Monticello, UT
NPI 1851624860 · NPPES record last updated Jul 10, 2024
Key facts
- NPI
- 1851624860
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 70948 (MT)
- Practice address
- 380 W 100 N Ste a
Monticello, UT 84535-7879 - Phone
- (435) 587-5041
- NPI assigned
- Sep 9, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- General Surgery
- Education
- Arizona College of Osteopathic Medicine Mid Western University, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Carson Tahoe Physician Clinics
CTH Physicians Clinic
Practice addresses (Care Compare)
2874 N Carson St
Suite 120
Carson City, NV 89706-1681
Phone (775) 888-6513
Hospital & facility affiliations
- Carson Tahoe Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (5 enrollments) in MT, UT, ME, CO, NV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190816000656 | MT | Practitioner - General Surgery | 9032398854 | |
| I20240710003974 | UT | Practitioner - General Surgery | 9032398854 | Reassigns benefits to 1 organization |
| I20250205001028 | ME | Practitioner - General Surgery | 9032398854 | |
| I20250211002680 | CO | Practitioner - General Surgery | 9032398854 | Reassigns benefits to 1 organization |
| I20250620001395 | NV | Practitioner - General Surgery | 9032398854 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70948 | MT | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Juan County Hospital | Current |
Accepting new patients | |
| Carson Tahoe Physician Clinics | Current |
Accepting new patients | |
| Banner Health Physicians Colorado LLC | Current |
Accepting new patients | |
| Carson Tahoe Regional Healthcare | Current |
Accepting new patients | |
| San Juan County Hospital | Current | Accepting new patients | |
| Banner Health Physicians Colorado LLC | Current |
Accepting new patients | |
| CTH Physicians Clinic | Current |
Accepting new patients | |
| Carson Tahoe Regional Healthcare | Current |
Accepting new patients | |
| San Juan County Hospital | Current |
Accepting new patients | |
| San Juan County Hospital | Past | Accepting new patients |
Locations
1800 15th St
Ste 200
Greeley, CO 80631
Phone (970) 348-0020
1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121
2874 N Carson St
Ste 200
Carson City, NV 89706
Phone (775) 283-3220
1600 Medical Pkwy
Carson City, NV 89703
Phone (775) 220-9149
704 W Nye Ln
Ste 102
Carson City, NV 89703
Phone (775) 687-8570
2874 N Carson St
Ste 120
Carson City, NV 89706
Phone (775) 445-5181
901 Medical Center Dr
Ste 203
Dayton, NV 89403
Phone (775) 445-7630
10539 Professional Cir
Ste 200
Reno, NV 89521
Phone (775) 445-7026
Interoperability endpoints
- astevens780883@direct.med.utah.edu
- https://fhir-myrecord.cerner.com/r4/d2bc3d5a-3c39-4553-86b1-b3aa0a5429a7/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 70948 | MT | Yes |
Addresses
Primary practice location
380 W 100 N Ste a
Monticello, UT 84535-7879
Mailing address
2391 E 3225 S
Salt Lake City, UT 84109-2719
Other providers in Monticello, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2024. 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.
- Order and Referring (CMS).
- 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.