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BROOKE STEPHANIE PROVOST M.D.
NPI 1801073812
Pediatrics - Hospice and Palliative Medicine in Salt Lake City, UT

Active since January 22, 2008PECOS Enrolled
100 N MARIO CAPECCHI DR STE 470, SALT LAKE CITY, UT 84113(801) 662-3770 Get Directions Write a Review

NPPES record last updated: August 27, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 27, 2026, Dec 11, 2015 (2 updates tracked since 2015).

About Brooke Stephanie Provost M.d. NPPES

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

BROOKE STEPHANIE PROVOST M.D. (NPI 1801073812) is an individual hospice and palliative medicine provider in Salt Lake City, Utah, licensed in Utah (6804174-1205) and active in the NPI registry since January 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1801073812
Entity TypeIndividualFemale
Primary Taxonomy2080H0002X
Provider Legal NameBROOKE STEPHANIE PROVOSTCredential: M.D.
Location Address100 N MARIO CAPECCHI DR STE 470Salt Lake City, UT 84113-1103
Mailing Address295 S Chipeta WaySalt Lake City, UT 84108-1287 · (801) 662-3770
Phone(801) 662-3770
Sole ProprietorNo
Enumeration DateJanuary 22, 2008
Last NPPES UpdateAugust 27, 20262 updates tracked since enumeration
NPPES CertifiedAugust 27, 2026
✔ NPI 1801073812 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Hospice and Palliative MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080H0002X
License✔ Licensed in UT · 6804174-1205
Definition
A pediatrician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.
Also ListedPediatricsTaxonomy 208000000X · License 68041741205 (UT)
100 N MARIO CAPECCHI DR STE 470, Salt Lake City, UT 84113
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Brooke Stephanie Provost M.d. 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 Brooke Provost 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 Pediatric Acuity Care
Same address
Pediatric Emergency Medicine
100 N MARIO CAPECCHI DR
Salt Lake City, UT 84113
  • Reassigned Medicare billing, Utah enrollment
  • 202 clinicians in this Medicare group
NPI 1538523675 (801) 587-6336
Ghs Partners In Health, Inc.
1,628 mi
Urology
135 PROFESSIONAL PARK DR
Seneca, SC 29678
  • Reassigned Medicare billing, South Carolina enrollment
  • Medicare enrollment name: Prisma Health University Medical Group
  • 3,281 clinicians in this Medicare group
NPI 1457730814 (864) 882-5306

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

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 Brooke Provost's NPI number?

The NPI number for Brooke Provost is 1801073812. It was assigned to this individual provider in the NPPES registry on January 22, 2008.

Where is Brooke Provost located?

Brooke Provost practices at 100 N Mario Capecchi Dr Ste 470, Salt Lake City, UT 84113. The listed phone number is (801) 662-3770.

What is Brooke Provost's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Hospice and Palliative Medicine, with taxonomy code 2080H0002X.

Is Brooke Provost enrolled in Medicare?

Yes. Brooke Provost is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Brooke Provost's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brooke Provost reassigns Medicare benefits to 2 organizations: University Of Utah Pediatric Acuity Care (Salt Lake City, UT) and Ghs Partners In Health, Inc. (Seneca, SC). 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 Brooke Provost's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Brooke Provost accept?

Health plans from Select Health list Brooke Provost 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 Brooke Provost was last updated on August 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.