DR. JON W AHLSTROM MD
NPI 1437146065
Obstetrics & Gynecology in Logan, UT

NPI Status: Active since September 29, 2005

Contact Information

550 E 1400 N
SUITE I
LOGAN, UT
ZIP 84341
Phone: (435) 753-1545

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
Hospital Affiliations - Privileges
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 36
Obstetrics & Gynecology
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting
CLIA Number: 46D0716310
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 08-31-2026

About JON AHLSTROM

This page provides the complete NPI Profile along with additional information for Jon Ahlstrom, a women's health care provider established in Logan, Utah with a medical specialization in Obstetrics & Gynecology and more than 36 years of experience. The healthcare provider is registered in the NPI registry with number 1437146065 assigned on September 2005. The practitioner's primary taxonomy code is 207V00000X with license number CP209732 (OR). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI: 1437146065
Provider Name: DR. JON W AHLSTROM MD
Gender: Male
Entity Type: Individual
Location Address: 550 E 1400 N SUITE I LOGAN, UT 84341
Location Phone: (435) 753-1545
Mailing Address: 550 E 1400 N SUITE I LOGAN, UT 84341
Mailing Phone: (435) 753-1545
Medical School Name: OTHER
Graduation Year: 1991
Is Sole Proprietor?: Yes
Enumeration Date: 09-29-2005
Last Update Date: 04-18-2022
Code Navigator

Women's health care providers like Jon Ahlstrom treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.

Location Map

Secondary Locations

675 N 5th St Ste 200
Lebanon, OR 97355
(541) 451-6282

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Obstetrics & Gynecology
Taxonomy Code: 207V00000X
Type: Allopathic & Osteopathic Physicians
License No.: CP209732
License State: OR
Taxonomy Description: An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	207V00000X	Allopathic & Osteopathic Physicians	Obstetrics & Gynecology	49187661205 (UT)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

BridgeSpan Health Company

BridgeSpan Standard Bronze Plan - EPO
BridgeSpan Standard Bronze Plan - HMO
BridgeSpan Standard Gold Plan - EPO
BridgeSpan Standard Gold Plan - HMO
BridgeSpan Standard Silver Plan - EPO
BridgeSpan Standard Silver Plan - HMO

Kaiser Permanente

KP OR Bronze 6000 - EPO
KP OR Bronze HSA 7100 - EPO
KP OR Gold 0 - EPO
KP OR Gold 1750 - EPO
KP OR Silver 3000 - EPO
KP OR Silver 4000 - EPO
KP Oregon Standard Bronze Plan - EPO
KP Oregon Standard Gold Plan - EPO
KP Oregon Standard Silver Plan - EPO
KP OR Family Dental - $100 Ded - EPO

Moda Health Plan, Inc.

Moda Health Affinity Bronze 8000 - EPO
Moda Health Affinity Bronze 9000 - EPO
Moda Health Affinity Bronze HDHP 7500 - EPO
Moda Health Affinity Gold 1000 - EPO
Moda Health Affinity Gold 1500 - EPO
Moda Health Affinity Gold 250 - EPO
Moda Health Affinity Silver 3000 - EPO
Moda Health Affinity Silver 3400 - EPO
Moda Health Affinity Silver 4500 - EPO
Moda Health Affinity Silver 6000 - EPO

Molina Healthcare

Molina Gold Core 1640 - HMO
Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
Molina Gold Standard - HMO
Molina Silver Core - HMO
Molina Silver Core Plus with Adult Dental and Vision - HMO
Molina Silver Core Plus with Adult Vision - HMO
Molina Silver Saver with Four Free PCP Visits - HMO
Molina Silver Standard - HMO

Providence Health Plan

HSA-E Qualified 7500 Bronze - Signature Network - EPO
Providence Oregon Standard Bronze Plan - Signature Network - EPO
Providence Oregon Standard Gold Plan - Signature Network - EPO
Providence Oregon Standard Silver Plan - Signature Network - EPO

Regence BlueCross BlueShield of Oregon

Bronze 8000 Individual Connect - EPO
Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
Bronze HSA 7000 Individual Connect - EPO
Gold 2300 Individual Connect - EPO
Regence Standard Bronze Plan Individual Connect - EPO
Regence Standard Gold Plan Individual Connect - EPO
Regence Standard Silver Plan Individual Connect - EPO
Silver 6500 Individual Connect - EPO

Regence BlueCross BlueShield of Utah

Bronze 8000 - EPO
Bronze Essential 9000 Deductible With 4 Copay No Deductible Office Visits - EPO
Bronze HSA 7000 - EPO
Gold 2300 - EPO
Regence Standard Bronze 7500 - EPO
Regence Standard Gold 2000 - EPO
Regence Standard Silver 6000 - EPO
Silver 6500 - EPO

Select Health

Med Benchmark Expanded Bronze Select Copay Plan - HMO
Med Benchmark Expanded Bronze Standardized Plan - HMO
Med Benchmark Gold Standardized Plan - HMO
Med Benchmark Platinum - HMO
Med Benchmark Platinum Standardized Plan - HMO
Med Benchmark Silver 6000 Medical Deductible w/Vision - HMO
Med Benchmark Silver Standardized Plan - HMO
Med Gold 1500 Medical Deductible - HMO
Value Benchmark Expanded Bronze Select Copay Plan - HMO
Value Benchmark Gold Standardized Plan - HMO

University of Utah Health Plans

Healthy Premier Bronze HSA - EPO
Healthy Premier Expanded Bronze Standard - EPO
Healthy Premier Gold Copay Office Visits - EPO
Healthy Premier Gold Standard - EPO
Healthy Premier Silver Copay Office Visits - EPO
Healthy Premier Silver Standard - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Jon Ahlstrom is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jon Ahlstrom is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 9537067103
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20050526000325
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Assessment of emotional or behavioral problems
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.42 for a new patient copayment and $17 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 84341 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $125.7
Minimum New Patient Price $54.34
Maximum New Patient Price $166.03

Average New Patient Copayment $31.42
Minimum New Patient Copayment $13.58
Maximum New Patient Copayment $41.5

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $68.01
Minimum Established Patient Price $17.23
Maximum Established Patient Price $135.2

Average Established Patient Copayment $17
Minimum Established Patient Copayment $4.3
Maximum Established Patient Copayment $33.8

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Breast Cancer Screening	74%	263
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Chronic Care and Preventative Care Management for Empaneled Patients	Yes	N/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
e-Prescribing	97%	1158
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Immunization Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Implementation of medication management practice improvements	Yes	N/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Medication Reconciliation	100%	432
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	81%	1392
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	34%	1156
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	91%	1135
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Provide Patient Access	100%	1392
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging	29%	1392
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Use of decision support and standardized treatment protocols	Yes	N/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Jon Ahlstrom is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type	Overall Rating
LOGAN REGIONAL HOSPITAL	1400 NORTH 500 EAST LOGAN, UT 84341	(435) 716-1000	Acute Care Hospitals
CACHE VALLEY HOSPITAL	2380 NORTH 400 EAST NORTH LOGAN, UT 84341	(435) 713-9700	Acute Care Hospitals

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 46D0716310
Facility Type: Physician Office
Certificate Effective Date: September 01, 2024
Certificate Expiration Date: August 31, 2026
Laboratory Director: JOHN W. AHLSTROM
Certificate Type: Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description: This CLIA certificate is issued to Jon Ahlstrom in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1437146065, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 6

Pos 4

Unchanged

Pos 5

Doubled → 2

Pos 6

Unchanged

Pos 7

Doubled → 12 → 1 + 2

Pos 8

Unchanged

Pos 9

Doubled → 12 → 1 + 2

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 1 → 2 6 → 12 → 3 6 → 12 → 3