GARRETT KORDSIEMON PA-C
NPI 1114654027
Physician Assistant - Medical in Riverton, UT

Active since August 02, 2022PECOS EnrolledAccepts Medicare Assignment
12391 S 4000 W, RIVERTON, UT 84096(801) 965-3600 Get Directions Write a Review

NPPES record last updated: September 9, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 9, 2025, Jun 19, 2024, Aug 2, 2022 (3 updates tracked since 2022).

About Garrett Kordsiemon Pa-c NPPES

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

GARRETT KORDSIEMON PA-C (NPI 1114654027) is an individual medical provider in Riverton, Utah, licensed in Utah (9374356-1206) and active in the NPI registry since August 2022. He is enrolled in Medicare PECOS, maintains a secondary practice location in Albuquerque, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1114654027
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameGARRETT KORDSIEMONCredential: PA-C
Location Address12391 S 4000 WRiverton, UT 84096-7012
Mailing Address2965 W 3500 SWest Valley City, UT 84119-3602 · (801) 965-3600
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateAugust 2, 2022
Last NPPES UpdateSeptember 9, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 9, 2025
NPI 1114654027 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in UT · 9374356-1206
12391 S 4000 W, Riverton, UT 84096

Secondary Practice Location 1

Location 11500 N Renaissance Blvd NEAlbuquerque, NM 87107-7002 · Phone (505) 266-5565

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Garrett Kordsiemon Pa-c 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 ID7810438660
PECOS Enrollment IDI20240919002199
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.

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.

Pediatrics
12391 S 4000 W
RIVERTON, UT 84096
Specialist
12391 S 4000 W, STE 208
RIVERTON, UT 84096
Dentist (General Practice)
12391 S 4000 W, SUITE 206
RIVERTON, UT 84096
Physician Assistant
12391 S 4000 W
RIVERTON, UT 84096
Nurse Practitioner (Primary Care)
12391 S 4000 W
RIVERTON, UT 84096
Nurse Practitioner (Family)
12391 S 4000 W
RIVERTON, UT 84096
Clinic/Center (Multi-Specialty)
12391 S 4000 W
RIVERTON, UT 84096
Nurse Practitioner
12391 S 4000 W
RIVERTON, UT 84096

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 Garrett Kordsiemon's NPI number?

The NPI number for Garrett Kordsiemon is 1114654027. It was assigned to this individual provider in the NPPES registry on August 2, 2022.

Where is Garrett Kordsiemon located?

Garrett Kordsiemon practices at 12391 S 4000 W, Riverton, UT 84096. The listed phone number is (801) 965-3600.

What is Garrett Kordsiemon's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Garrett Kordsiemon enrolled in Medicare?

Yes. Garrett Kordsiemon 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.

What insurance does Garrett Kordsiemon accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Garrett Kordsiemon 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.

When was this NPI record last updated?

The NPPES record for Garrett Kordsiemon was last updated on September 9, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.