ALTA PAIN PHYSICIANS, PLLC — NPI 1063721850 (Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Interventional Pain Medicine in SANDY, UT)

CMS-1500 Box 24J / 33a • NPI

1063721850

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

208VP0014X (CMS 09)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Interventional Pain Medicine

Box 32 Service Location & ZIP+4

11449 S 1000 E STE 102, SANDY, UT, 84094-5584

✓ 9-Digit EDI 837 ZIP+4 (84094-5584)

Practice Phone & Referral Fax

(801) 462-2205

Fax: (801) 326-4675

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1063721850 (ALTA PAIN PHYSICIANS, PLLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1063721850` (NPI-2 Organization / Facility)
Provider / Legal Name	ALTA PAIN PHYSICIANS, PLLC
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Interventional Pain Medicine NUCC Code: `208VP0014X` (Pain Medicine, Interventional Pain Medicine)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	11449 S 1000 E STE 102, SANDY, UT, 84094-5584
Practice Telephone / Fax	Tel: (801) 462-2205 \| Fax: (801) 326-4675
Administrative Mailing Address	11449 S 1000 E STE 102, SANDY, UT, 84094-5584
Enumeration & Last Sync	Enumerated: 2010-09-28 \| CMS Record Updated: 2025-12-03
Authorized Official	MICHEAL CHEN (Authorized Official)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

11449 S 1000 E STE 102, SANDY, UT, 84094-5584

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Plain-English Taxonomy & CMS Crosswalk (208VP0014X)

What Does Taxonomy Code 208VP0014X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208VP0014X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Interventional Pain Medicine"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 09 (Physician/Interventional Pain Management)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Pain Medicine, Interventional Pain Medicine for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ALTA PAIN PHYSICIANS, PLLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`208VP0014X` — Pain Medicine, Interventional Pain Medicine Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Interventional Pain Medicine	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ALTA PAIN PHYSICIANS, PLLC (NPI #1063721850)