JAKE FAGAN MD
NPI 1548688989
Dermatology - MOHS-Micrographic Surgery in Provo, UT

Q: What is Jake Fagan's NPI number?

The NPI number for Jake Fagan is 1548688989. It was assigned to this individual provider in the NPPES registry on April 2, 2014.

Q: What is Jake Fagan's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Q: When was this NPI record last updated?

The NPPES record for Jake Fagan was last updated on April 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since April 02, 2014PECOS EnrolledAccepts Medicare Assignment

94.3/100

CMS Quality Rating

1055 N 500 W # 111, PROVO, UT 84604(801) 374-8999 Get Directions Write a Review

NPPES record last updated: April 17, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 17, 2024, Feb 18, 2021, Apr 17, 2019 (3 updates tracked since 2019).

On this page

About Jake Fagan Md NPPES

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

JAKE FAGAN MD (NPI 1548688989) is an individual mohs-micrographic surgery provider in Provo, Utah, licensed in Utah (6845592-1205) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS, maintains a secondary practice location in Billings, and is a graduate of West Virginia University School Of Medicine (2014).

NPPES Registry Identity

NPI1548688989

Entity TypeIndividualMale

Primary Taxonomy207ND0101X

Provider Legal NameJAKE FAGANCredential: MD

Location Address1055 N 500 W # 111Provo, UT 84604-3305

Mailing Address1055 N 500 W, Att CredentialingProvo, UT 84604 · (801) 354-8225 · Fax (801) 418-0941

Phone(801) 374-8999

Sole ProprietorNo

Medical School CMSWest Virginia University School Of MedicineGraduated 2014

Enumeration DateApril 2, 2014

Last NPPES UpdateApril 17, 20243 updates tracked since enumeration

NPPES CertifiedApril 3, 2024

✔ NPI 1548688989 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207ND0101X

Licenses✔ Licensed in UT · 6845592-1205✔ Licensed in MT · MED-PHYS-LIC-76211✔ Licensed in MT · 76211

Definition

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

Also ListedDermatologyTaxonomy 207N00000X · License MED-PHYS-LIC-76211 (MT)

Also ListedSurgery · Surgical OncologyTaxonomy 2086X0206X · License MED-PHYS-LIC-76211 (MT)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1055 N 500 W # 111, Provo, UT 84604

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Secondary Practice Location 1

Location 1801 N 29th StBillings, MT 59101-0905 · Phone (406) 238-2500

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Imperial Health Plan of the Southwest, Inc., Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jake Fagan Md 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 ID3577868264

PECOS Enrollment IDI20240522002957

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.

Areas of Expertise CMS Part B claims 35

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.

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks 17311

This procedure involves the careful removal of a growth from the head, neck, hands, or feet. The removed tissue, divided into 1-5 blocks, is then examined under a microscope to study its characteristics and determine the nature of the growth.

243 services208 patients

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks 17311

178 services137 patients

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks 17312

This procedure involves the careful removal of abnormal growths from the head, neck, hands, or feet. The removed tissues, divided into 1-5 blocks, are then examined under a microscope to identify any irregularities. The process may be carried out in multiple stages for thorough examination.

149 services74 patients

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks 17312

142 services92 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

95 services87 patients

Destruction of precancer skin growth, 2-14 growths 17003

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

81 services36 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

76 services70 patients

Destruction of precancer skin growth, 2-14 growths 17003

59 services20 patients

Biopsy of related skin growth, first growth 11102

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

55 services52 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

49 services49 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

49 services49 patients

Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm 12052

This procedure involves repairing a wound on the face, ears, eyelids, nose, lips, or mouth that measures between 2.6-5.0 cm. The process includes cleaning, suturing if necessary, and dressing the wound to promote healing and prevent infection.

46 services46 patients

Destruction of precancer skin growth, 1 growth 17000

46 services44 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

43 services42 patients

Biopsy of related skin growth, first growth 11102

42 services41 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

41 services36 patients

Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm 12052

32 services32 patients

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm 13132

This procedure involves the complex repair of a wound in areas like the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The wound size ranges from 2.6-7.5 cm. The process includes cleaning, removing damaged tissue, and stitching the wound for proper healing.

24 services24 patients

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less 14060

This procedure involves repairing a wound on the eyelids, nose, ears, or lips by moving a small piece of skin (10.0 sq cm or less) from one area to another. The goal is to heal the wound and restore the function and appearance of the affected area.

24 services23 patients

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm 13132

23 services23 patients

Pathology examination of specimen during surgery, first tissue block 88331

A pathology examination during surgery involves the immediate analysis of a removed tissue sample. This helps the surgeon make decisions during your operation. The "first tissue block" refers to the initial sample examined. It's a vital step to ensure your health.

23 services17 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

18 services18 patients

Biopsy of related skin growth, each additional growth 11103

A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.

17 services11 patients

Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less 12051

This procedure involves repairing a wound on your face, ears, eyelids, nose, lips, or mouth. The wound is 2.5 cm or less in size. The repair process includes cleaning, treating, and stitching the wound to promote optimal healing. It's a standard, safe procedure.

16 services15 patients

Biopsy of related skin growth, each additional growth 11103

15 services11 patients

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm 12032

This procedure involves the repair of a wound between 2.6-7.5 cm located on the scalp, underarms, trunk, arms, or legs. The process includes cleaning, debridement (removal of damaged tissue), and suturing (stitching) of the wound to promote healing.

15 services15 patients

Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm 12042

This is a procedure to mend a moderate wound between 2.6-7.5 cm on your neck, hands, or feet. It involves cleaning the wound, removing any damaged tissue, and stitching it back together to promote healing and minimize scarring.

15 services15 patients

Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm 13152

This procedure involves repairing a wound on your eyelids, nose, ears, or lip that is between 2.6 and 7.5 cm long. It's considered complicated due to the location and size. The doctor will clean, treat, and stitch the wound to promote healing.

15 services15 patients

Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm 13152

15 services15 patients

Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm 17262

This procedure involves removing a cancerous skin growth on the trunk, arms, or legs that is between 1.1 and 2.0 cm in size. The growth is destroyed using methods like surgery, laser, or freezing, aiming to eliminate cancer and prevent its spread.

15 services14 patients

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less 14060

13 services12 patients

Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks 17313

This procedure involves the removal of a growth from your trunk, arms, or legs. The removed tissue, divided into 1-5 blocks, is then examined under a microscope to identify any abnormalities. This helps in diagnosing and planning further treatment.

13 services11 patients

Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm 13151

This procedure involves the intricate repair of a wound that is 1.1 to 2.5 cm long on your eyelids, nose, ears, or lip. The goal is to mend the wound carefully to preserve function and minimize scarring. The process may involve stitching and other techniques.

11 services11 patients

Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm 13151

11 services11 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

11 services11 patients

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.

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

$68.01 typical visit price

range $17.23 – $135.20

Typical copayment $17.00 (range $4.30 – $33.80)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.3/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

85.58

Promoting Interoperability

100

Improvement Activities

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 Jake Fagan's NPI number?

The NPI number for Jake Fagan is 1548688989. It was assigned to this individual provider in the NPPES registry on April 2, 2014.

Where is Jake Fagan located?

Jake Fagan practices at 1055 N 500 W # 111, Provo, UT 84604. The listed phone number is (801) 374-8999.

What is Jake Fagan's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Jake Fagan enrolled in Medicare?

Yes. Jake Fagan 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.

What insurance does Jake Fagan accept?

Health plans from BridgeSpan Health Company, Imperial Health Plan of the Southwest, Inc., Molina Healthcare, Providence Health Plan and Regence BlueCross BlueShield of Utah and 2 other insurers list Jake Fagan 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 Jake Fagan was last updated on April 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.