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DR. AMMAR ALI MUBARAK ASBAN MBBS
NPI 1053727719
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Salt Lake City, UT

Active since July 02, 2014PECOS EnrolledAccepts Medicare Assignment
30 N 1900 E, SALT LAKE CITY, UT 84132(801) 581-4222 Get Directions Write a Review

NPPES record last updated: June 30, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 30, 2025, Jun 25, 2025, Oct 11, 2016 (3 updates tracked since 2016).

About Dr. Ammar Ali Mubarak Asban Mbbs NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. AMMAR ALI MUBARAK ASBAN MBBS (NPI 1053727719) is an individual thoracic surgery (cardiothoracic vascular surgery) provider in Salt Lake City, Utah, licensed in Georgia (105134) and active in the NPI registry since July 2014. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1053727719
Entity TypeIndividualMale
Primary Taxonomy208G00000X
Provider Legal NameDR. AMMAR ALI MUBARAK ASBANCredential: MBBS
Location Address30 N 1900 ESalt Lake City, UT 84132-0002
Mailing Address30 N 1900 ESalt Lake City, UT 84132-0002 · (801) 581-4222
Phone(801) 581-4222
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateJuly 2, 2014
Last NPPES UpdateJune 30, 20253 updates tracked since enumeration
NPPES CertifiedJune 30, 2025
✔ NPI 1053727719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians
Taxonomy Code208G00000X
Licenses✔ Licensed in GA · 105134✔ Licensed in UT · 12779409-1205
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
Also ListedSurgeryTaxonomy 208600000X · License 260348 (MA)
30 N 1900 E, Salt Lake City, UT 84132
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1631 Professional Dr Ste 470Lawrenceville, GA 30046-3370 · Phone (678) 312-1940 · Fax (678) 312-1929
Location 2800 Washington St, 4Boston, MA 02111-1552 · Phone (617) 636-5891 ext. 5891

Other Identifiers 1

OtherS68018745MA · Driver's License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Ammar Ali Mubarak Asban Mbbs is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9931497369
PECOS Enrollment IDI20250728004124
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Ammar Asban reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Northside Surgical Professional Services LLC
1,580 mi
Surgery
1000 JOHNSON FERRY RD NE
Atlanta, GA 30342
  • Reassigned Medicare billing, Georgia enrollment
  • 487 clinicians in this Medicare group
NPI 1356630990 (855) 709-4535
New York University
2,061 mi
Cardiovascular Disease
3301 QUANTUM BLVD
Boynton Beach, FL 33426
  • Reassigned Medicare billing, New York enrollment
  • 7,712 clinicians in this Medicare group
NPI 1285826438 (877) 648-2964

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110005
Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County
Birthing friendly

Northside Hospital Cherokee

Acute Care Hospitals · Canton, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110008
Location450 Northside Cherokee BoulevardCanton, GA 30115 · Cherokee County
Emergency services Birthing friendly

Northside Hospital Gwinnett

Acute Care Hospitals · Lawrenceville, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110087
Location1000 Medical Center BoulevardLawrenceville, GA 30046 · Gwinnett County
Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110161
Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84132 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$166.03 typical visit price
range $54.34 – $166.03
Typical copayment $41.50 (range $13.58 – $41.50)
Most-billed visit code 99205
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANNE WIERMAN ESTARES D.O.
Anesthesiology
30 N 1900 E, RM 4C104
SALT LAKE CITY, UT 84132
Salt Lake County (719) 314-5254
DR. JEFFREY DAVID DILLON M.D.
Anesthesiology
30 N 1900 E, ROOM 3C444
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-6393
QUINTON ALLRED PA-C
Physician Assistant (Medical)
30 N 1900 E
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7822
JEREMY ROYLE STODDART MD
Psychiatry & Neurology (Psychiatry)
30 N 1900 E, UNIVERSITY HOSPITAL,
SLC, UT 84132
Salt Lake County (801) 581-2121
DR. STEPHEN JAMES SUMMERS M.D.
Urology
30 N 1900 E, RM 3B420
SALT LAKE CITY, UT 84132
Salt Lake County (801) 213-2700
CHRISTINA MARIE DERBIDGE PHD
Psychologist (Clinical)
30 N 1900 E, ROOM SOM 1-B620
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-6228
ANDRIA HOLMES HOLT RN
Nurse Practitioner (Obstetrics & Gynecology)
30 N 1900 E
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7647
ANDY NGUYEN
Internal Medicine
30 N 1900 E, SOM4C104
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7899

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ammar Asban's NPI number?

The NPI number for Ammar Asban is 1053727719. It was assigned to this individual provider in the NPPES registry on July 2, 2014.

Where is Ammar Asban located?

Ammar Asban practices at 30 N 1900 E, Salt Lake City, UT 84132. The listed phone number is (801) 581-4222.

What is Ammar Asban's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Is Ammar Asban enrolled in Medicare?

Yes. Ammar Asban is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Ammar Asban's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ammar Asban reassigns Medicare benefits to 2 organizations: Northside Surgical Professional Services LLC (Atlanta, GA) and New York University (Boynton Beach, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ammar Asban's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ammar Asban accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Ammar Asban as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Ammar Asban affiliated with any hospitals?

According to CMS data, Ammar Asban is affiliated with Northside Hospital Forsyth, Northside Hospital Cherokee, Northside Hospital Gwinnett and Northside Hospital.

When was this NPI record last updated?

The NPPES record for Ammar Asban was last updated on June 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.