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JUSTIN ALAN ILLUM
NPI 1265174452
Nurse Practitioner - Family in Midvale, UT

Active since April 08, 2022PECOS EnrolledAccepts Medicare Assignment
971 E CREEKHILL LN APT 10, MIDVALE, UT 84047(417) 693-3850 Get Directions Write a Review

NPPES record last updated: December 8, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 8, 2024, Aug 12, 2023, Apr 8, 2022 (3 updates tracked since 2022).

About Justin Alan Illum NPPES

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

JUSTIN ALAN ILLUM (NPI 1265174452) is an individual family provider in Midvale, Utah, licensed in Utah (10386297-4405) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS, is affiliated with University Of Utah Hospitals And Clinics, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1265174452
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameJUSTIN ALAN ILLUM
Location Address971 E CREEKHILL LN APT 10Midvale, UT 84047-2365
Mailing Address971 E Creekhill Ln Apt 10Midvale, UT 84047-2365 · (417) 693-3850
Phone(417) 693-3850
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateApril 8, 2022
Last NPPES UpdateDecember 8, 20243 updates tracked since enumeration
NPPES CertifiedDecember 8, 2024
✔ NPI 1265174452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in UT · 10386297-4405
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
971 E CREEKHILL LN APT 10, Midvale, UT 84047
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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

Justin Alan Illum 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 ID4385094911
PECOS Enrollment IDI20231222001593
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 Justin Illum reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Utah Adult Services
2.1 mi
Neurology
175 N MEDICAL DR
Salt Lake City, UT 84132
  • Reassigned Medicare billing, Utah enrollment
  • 2,620 clinicians in this Medicare group
NPI 1578967345 (801) 585-7575
Signify Health, LLC
986 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Utah enrollment
  • 145 clinicians in this Medicare group
NPI 1689158487 (469) 466-7007

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

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
69 services33 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
24 services21 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
24 services20 patients

Hospital Affiliations CMS Care Compare

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

University Of Utah Hospitals And Clinics

Acute Care Hospitals · Salt Lake City, UT
5/5 CMS rating
OwnershipGovernment - State
CMS Certification Number460009
Location50 North Medical DriveSalt Lake City, UT 84132 · Salt Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84047 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Justin Illum's NPI number?

The NPI number for Justin Illum is 1265174452. It was assigned to this individual provider in the NPPES registry on April 8, 2022.

Where is Justin Illum located?

Justin Illum practices at 971 E Creekhill Ln Apt 10, Midvale, UT 84047. The listed phone number is (417) 693-3850.

What is Justin Illum's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Justin Illum enrolled in Medicare?

Yes. Justin Illum 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 Justin Illum's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Justin Illum reassigns Medicare benefits to 2 organizations: University Of Utah Adult Services (Salt Lake City, UT) and Signify Health, LLC (Dallas, TX). 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 Justin Illum's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Justin Illum affiliated with any hospitals?

According to CMS data, Justin Illum is affiliated with University Of Utah Hospitals And Clinics.

When was this NPI record last updated?

The NPPES record for Justin Illum was last updated on December 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.