DR. TODD B ENGEN (NPI# 1295705697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295705697 |
| Entity Type | Individual |
| Full Name | DR. TODD B ENGEN |
| Credential | MD |
| Practice Address |
1735 N State St Provo UT 84604-1010 |
| Mailing Address |
1735 N State St Suite 201 Provo UT 84604-1010 |
| Practice Telephone | 8013792900 |
| Practice Fax Number | 8013746295 |
| Mailing Telephone | 8013792900 |
| Mailing Fax Number | 8013746295 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2017-04-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
983591001205 | UT | Allopathic & Osteopathic Physicians |
| Y | 207WX0200X |
Ophthalmology Specialization: Ophthalmic Plastic and Reconstructive Surgery |
3591001205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | UNITED HEALTHCARE | 0880213 | 01 |
| UT | CIGNA | 1435708001 | 01 |
| UT | EMIA | 204371916TBE | 01 |
| UT | TRICARE | 87028357684601A001 | 01 |
| UT | ALTIUS | QM0000053146 | 01 |
| UT | SELECT HEALTH | 107007206102 | 01 |
| UT | AFFORDABLE | 1146594 | 01 |
| UT | PGBA | 87028357684604C001 | 01 |
| Street Address |
1735 N STATE ST |
| City | PROVO |
| State | UT |
| Zip Code | 84604-1010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821657222 | Reese Mark Loveless | Optometrist | 1735 N State St, Provo, UT 84604-1010 | 2019-06-10 |
| 1134674278 | Nathan Lambert | Ophthalmology | 1735 N State St, Provo, UT 84604-1010 | 2016-08-18 |
| 1467838094 | Bradley Henriksen | Ophthalmology | 1735 N State St, Provo, UT 84604-1010 | 2015-08-05 |
| 1255727905 | Christopher Ricks | Ophthalmology | 1735 N State St, Provo, UT 84604-1010 | 2015-04-09 |
| 1952664468 | Mason Antone Schmutz | Ophthalmology | 1735 N State St, Provo, UT 84604-1010 | 2012-06-19 |
| 1477870814 | Joseph S Schmutz | Ophthalmology | 1735 N State St, Provo, UT 84604-1010 | 2010-04-26 |
| 1396937074 | Justin Wilkinson | Ophthalmology | 1735 N State St, Provo, UT 84604 | 2007-08-15 |
| 1669676086 | William V Hatch | Optometrist | 1735 N State St, Provo, UT 84604-1010 | 2007-06-11 |
| 1851422703 | Excel Cosmetic Surgery Center | Surgery | 1735 N State St, Provo, UT 84604-1010 | 2007-03-09 |
| 1396831483 | Central Utah Optical | Eyewear Supplier (Equipment, not the service) | 1735 N State St, Provo, UT 84604-1010 | 2006-10-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 207WX0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Ophthalmic Plastic and Reconstructive Surgery |
| A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck. |
| Notes: Source: American Academy of Ophthalmology, 2015. www.aao.org [1/1/2016: new] |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.