Active NPI
Anna Aller Lara, PAC
- Physician Assistant
- Logan, UT
National Provider Identifier
1861761975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 8170100-1206
- Practice address
- 1325 N 600 E Ste 102
Logan, UT 84341-6744 - Phone
- (435) 753-9999
- Fax
- (435) 753-2301
- NPI assigned
- Dec 19, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 8170100-1206 | UT | Primary |
Addresses
Primary practice location
1325 N 600 E Ste 102
Logan, UT 84341-6744
Mailing address
1325 N 600 E Ste 102
Logan, UT 84341-6744
Phone (435) 753-9999
Other names 1
- Anna A Lara
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240325002497 | UT | Practitioner - Physician Assistant | 2264752658 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Touro Un Col of Osteopathic Medicine, Henderson, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1325 N 600
Suite 102
Logan, UT 84341-6744
Phone (435) 753-9999
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480377600000",
"number": "1861761975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1325 N 600 E STE 102",
"city": "LOGAN",
"state": "UT",
"postal_code": "843416744",
"telephone_number": "435-753-9999",
"fax_number": "435-753-2301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 N 600 E STE 102",
"city": "LOGAN",
"state": "UT",
"postal_code": "843416744",
"telephone_number": "435-753-9999",
"fax_number": "435-753-2301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARA",
"first_name": "ANNA",
"middle_name": "ALLER",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-19",
"last_updated": "2016-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "8170100-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANNA",
"last_name": "LARA",
"middle_name": "A",
"credential": "PAC",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.