ETHAN MARK NIELSEN PA
NPI 1154179844
Physician Assistant in Provo, UT
About Ethan Mark Nielsen Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ETHAN MARK NIELSEN PA (NPI 1154179844) is an individual physician assistant in Provo, Utah, licensed in Utah (14245351-1206) and active in the NPI registry since May 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses 2
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ethan Mark Nielsen Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 84604 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
PROVO, UT 84604
PROVO, UT 84604
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 Ethan Nielsen's NPI number?
The NPI number for Ethan Nielsen is 1154179844. It was assigned to this individual provider in the NPPES registry on May 8, 2024.
Where is Ethan Nielsen located?
Ethan Nielsen practices at 395 W Bulldog Blvd, Provo, UT 84604. The listed phone number is (801) 357-7081.
What is Ethan Nielsen's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Ethan Nielsen enrolled in Medicare?
Yes. Ethan Nielsen is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Ethan Nielsen was last updated on November 21, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.
