Individual provider Active NPI

Brian Arthur Ekberg, PA-C

  • Medical Physician Assistant
  • Bountiful, UT
National Provider Identifier
1992759583
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10504077-1206 Issued in UT
Practice address
520 Medical Dr Ste 300
Bountiful, UT 84010-8925
Phone
(801) 292-1422
Fax
(801) 296-0436
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10504077-1206 UT Primary

Addresses

Primary practice location

520 Medical Dr Ste 300
Bountiful, UT 84010-8925

Mailing address

520 Medical Dr Ste 300
Bountiful, UT 84010-8925
Phone (801) 292-1422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060811000266 NV Practitioner - Physician Assistant 2769485754 Reassigns benefits to 1 organization
I20180112000742 UT Practitioner - Physician Assistant 2769485754 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

520 Medical Dr
Suite 300
Bountiful, UT 84010-4968

Hospital & facility affiliations

  • Lakeview Hospital Hospital, Bountiful, UT, CCN 460042

Merit-based Incentive Payment System (MIPS)

Final score
73 of 100Reported as apm
Quality
86.2
Promoting interoperability
33
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jordan Ridge Family Medicine LLC CurrentSince May 24, 2023 Accepting new patients
Jordan Ridge Family Medicine LLC CurrentSince May 24, 2023 Accepting new patients
Joshua Oaks MD PLLC Past Accepting new patients
Intermountain Medical Holdings Nevada Inc Past Accepting new patients
Linda L. Johnson MD, LTD Past Accepting new patients

Locations

6321 S Redwood Rd
Ste 201
Taylorsville, UT 84123
Phone (801) 265-2212

Interoperability endpoints

  • Direct secure messaging: brianekberg@optmct.allscriptsdirect.net
  • Direct secure messaging: brian.ekberg.1@16218.direct.athenahealth.com

Organizations & group practices 8

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1992759583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MEDICAL DR STE 300",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108925",
            "telephone_number": "801-292-1422",
            "fax_number": "801-296-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MEDICAL DR STE 300",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108925",
            "telephone_number": "801-292-1422",
            "fax_number": "801-296-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKBERG",
        "first_name": "BRIAN",
        "middle_name": "ARTHUR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "10504077-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.