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DESERT BLOOM PLASTIC SURGERY LLC
NPI 1235691510
Clinic/Center - Medical Specialty in St George, UT

Active since April 04, 2019
446 S MALL DR STE 1, ST GEORGE, UT 84790(435) 627-8150 Get Directions Write a Review

NPPES record last updated: January 2, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 2, 2025, Apr 4, 2019 (2 updates tracked since 2019).

About Desert Bloom Plastic Surgery Llc NPPES

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

DESERT BLOOM PLASTIC SURGERY LLC (NPI 1235691510) is a healthcare organization registered as a medical specialty in St George, Utah and active in the NPI registry since April 2019. The organization lists Jordan Wallin, President, as its authorized official.

NPPES Registry Identity

NPI1235691510
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameDESERT BLOOM PLASTIC SURGERY LLC
Location Address446 S MALL DR STE 1St George, UT 84790-4944
Mailing Address446 S Mall Dr Ste 1St George, UT 84790-4944 · (435) 627-8150
Phone(435) 627-8150
Organization SubpartNo
Authorized OfficialJordan WallinPresident · (435) 627-8150
Enumeration DateApril 4, 2019
Last NPPES UpdateJanuary 2, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 2, 2025
✔ NPI 1235691510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
446 S MALL DR STE 1, St George, UT 84790
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include University of Utah Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Desert Bloom Plastic Surgery Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Desert Bloom Plastic Surgery LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jordan Wallin, M.D.
Otolaryngology
NPI 1811177652
446 S MALL DR STE B1
St George, UT 84790
(435) 627-8150
✔ PECOS✔ Accepts MedicareSame address

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

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 Desert Bloom Plastic Surgery LLC's NPI number?

The NPI number for Desert Bloom Plastic Surgery LLC is 1235691510. It was assigned to this organization in the NPPES registry on April 4, 2019.

Where is Desert Bloom Plastic Surgery LLC located?

Desert Bloom Plastic Surgery LLC is located at 446 S Mall Dr Ste 1, St George, UT 84790. The listed phone number is (435) 627-8150.

What is Desert Bloom Plastic Surgery LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Is Desert Bloom Plastic Surgery LLC enrolled in Medicare?

Yes. Desert Bloom Plastic Surgery LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Desert Bloom Plastic Surgery LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Otolaryngology) reassigns their Medicare billing to Desert Bloom Plastic Surgery LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Desert Bloom Plastic Surgery LLC accept?

Health plans from University of Utah Health Plans list Desert Bloom Plastic Surgery LLC 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 Desert Bloom Plastic Surgery LLC was last updated on January 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.