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AARON PROVANCE MD
NPI 1710024005
Pediatrics - Sports Medicine in Salt Lake City, UT

Active since January 30, 2007PECOS Enrolled
590 S WAKARA WAY, SALT LAKE CITY, UT 84108(801) 587-7109 Get Directions Write a Review

NPPES record last updated: June 25, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 25, 2023, Oct 20, 2022, Apr 12, 2021 and 1 more (4 updates tracked since 2018).

About Aaron Provance Md NPPES

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

AARON PROVANCE MD (NPI 1710024005) is an individual sports medicine provider in Salt Lake City, Utah, licensed in Utah (12804185-1205) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710024005
Entity TypeIndividualMale
Primary Taxonomy2080S0010X
Provider Legal NameAARON PROVANCECredential: MD
Location Address590 S WAKARA WAYSalt Lake City, UT 84108-7106
Mailing Address590 S Wakara WaySalt Lake City, UT 84108 · (801) 587-7109
Phone(801) 587-7109
Sole ProprietorNo
Enumeration DateJanuary 30, 2007
Last NPPES UpdateJune 25, 20234 updates tracked since enumeration
NPPES CertifiedJune 25, 2023
✔ NPI 1710024005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080S0010X
Licenses✔ Licensed in UT · 12804185-1205✔ Licensed in CO · DR.0044594
Definition
A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
590 S WAKARA WAY, Salt Lake City, UT 84108
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Aaron Provance Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Aaron Provance 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
Same address
Orthopaedic Surgery
590 S WAKARA WAY
Salt Lake City, UT 84108
  • Reassigned Medicare billing, Utah enrollment
  • 2,620 clinicians in this Medicare group
NPI 1932503430 (801) 581-2121
University Of Utah Pediatric Services
1.0 mi
Pediatric Allergy/Immunology
81 N MARIO CAPECCHI DR
Salt Lake City, UT 84113
  • Reassigned Medicare billing, Utah enrollment
  • 751 clinicians in this Medicare group
NPI 1023472594 (801) 587-6336

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

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAYLA L. GATES MD
Orthopaedic Surgery
590 S WAKARA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-5448
THOMAS HONG MD
Student in an Organized Health Care Education/Training Program
590 S WAKARA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7109
ANDREW KOSTURIK
Physical Therapist
590 S WAKARA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7109
LUIS B. FANDINO MD
Orthopaedic Surgery
590 S WAKARA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-5448
NAOMI RUTH LAIRD PA-C
Physician Assistant
590 S WAKARA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7109
DENNIS N. JACKSON MD
Emergency Medicine
590 S WAKARA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 581-2121
TREVOR WILTZ DPT
Physical Therapist
590 S WAKARA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7109
DR. JOSHUA KURT JOHNSON DPT
Physical Therapist
590 S WAKARA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7109

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 Aaron Provance's NPI number?

The NPI number for Aaron Provance is 1710024005. It was assigned to this individual provider in the NPPES registry on January 30, 2007.

Where is Aaron Provance located?

Aaron Provance practices at 590 S Wakara Way, Salt Lake City, UT 84108. The listed phone number is (801) 587-7109.

What is Aaron Provance's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Sports Medicine, with taxonomy code 2080S0010X.

Is Aaron Provance enrolled in Medicare?

Yes. Aaron Provance is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Aaron Provance's services?

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

What insurance does Aaron Provance accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Aaron Provance 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 Aaron Provance was last updated on June 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.