PROVO SURGERY CENTER, LLC
NPI 1639853757
Clinic/Center - Ambulatory Surgical in Provo, UT
NPI Status: Active since June 09, 2023
Contact Information
1157 N 300 W
PROVO, UT
ZIP 84604
Phone: (385) 283-1906
- Organization
- Clinic/Center
- Ambulatory Surgical
- Accepts Insurance
- CLIA Number: 46D2284821
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 06-28-2027
About PROVO SURGERY CENTER, LLC
This page provides the complete NPI Profile along with additional information for Provo Surgery Center, Llc, a provider established in Provo, Utah operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1639853757 assigned on June 2023. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's
- NPI
- 1639853757
- Provider Legal Name
- PROVO SURGERY CENTER, LLC
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 1157 N 300 W PROVO, UT 84604
- Location Phone
- (385) 283-1906
- Mailing Address
- 1157 N 300 W PROVO, UT 84604
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-09-2023
- Last Update Date
- 11-25-2025
- Code Navigator
Location Map
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
Clinic/Center Ambulatory Surgical
- Taxonomy Code
- 261QA1903X
- Type
- Ambulatory Health Care Facilities
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- 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
- 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
- Signature Benchmark Gold - HMO
- Signature Benchmark Gold Standardized Plan - HMO
- Signature Benchmark Silver 5900 Medical Deductible - HMO
- Signature Benchmark Silver Standardized Plan - HMO
- Value Benchmark Expanded Bronze Select Copay Plan - HMO
- Value Benchmark Gold Standardized Plan - HMO
- Value Benchmark Platinum - HMO
- Value Benchmark Platinum Standardized Plan - HMO
- Value Benchmark Silver 5900 Medical Deductible - HMO
- Value Benchmark Silver Standardized Plan - HMO
- Value Expanded Bronze 6900 Medical Deductible - HMO
- Value Gold 1500 Medical Deductible - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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
- 46D2284821
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- June 29, 2025
- Certificate Expiration Date
- June 28, 2027
- Laboratory Director
- MATTHEW WAGAMAN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Provo Surgery Center, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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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 1639853757, we treat the final digit (7) 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 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 73 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
PROVO, UT 84604
PROVO, UT 84604
PROVO, UT 84604
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639853757, enumerated as an "organization" on June 09, 2023.
The provider is located at 1157 N 300 W PROVO, UT 84604 and the phone number is (385) 283-1906.
Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.
The provider might be accepting Accepts: Molina Healthcare and Select Health. Please consult your insurance carrier or call the provider to verify.
