MARK R BRIESACHER MD
NPI 1154333029
Pediatrics in Salt Lake City, UT
About Mark R Briesacher Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARK R BRIESACHER MD (NPI 1154333029) is an individual pediatrics provider in Salt Lake City, Utah, licensed in Utah (932637891205) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mark R Briesacher Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mark Briesacher reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Holladay, UT 84117
- Reassigned Medicare billing, Utah enrollment
- 3,691 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 84117 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.
HOLLADAY, UT 84117
SALT LAKE CITY, UT 84117
HOLLADAY, UT 84117
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 Mark Briesacher's NPI number?
The NPI number for Mark Briesacher is 1154333029. It was assigned to this individual provider in the NPPES registry on August 12, 2006.
Where is Mark Briesacher located?
Mark Briesacher practices at 2180 E 4500 S #210, Salt Lake City, UT 84117. The listed phone number is (801) 278-4719.
What is Mark Briesacher's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Mark Briesacher enrolled in Medicare?
Yes. Mark Briesacher is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mark Briesacher's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mark Briesacher reassigns Medicare benefits to Ihc Health Services Inc (Holladay, UT). The 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 Mark Briesacher's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mark Briesacher was last updated on December 1, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.
# Mark R Briesacher, MD · NPI 1154333029
Pediatrics physician in Salt Lake City, Utah. Individual provider, active in the CMS NPPES registry since August 12, 2006.
## Identity
- **NPI:** 1154333029 (Entity type: Individual)
- **Enumerated:** August 12, 2006
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 932637891205 (Utah)
- **Sole proprietor:** No
## Practice location
- **Address:** 2180 E 4500 S, #210, Salt Lake City, UT 84117-4434
- **Phone:** (801) 278-4719
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Ihc Health Services Inc (NPI 1558496745, Holladay, UT), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 1, 2008
- **Other identifiers:** Medicare PIN 000063084 (UT)
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Source: [NPI Profile](https://npiprofile.com/npi/1154333029) · Data from the CMS NPPES public registry.