CMS-1500 Box 24J / 33a • NPI
1720442775
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363L00000X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner
Box 32 Service Location & ZIP+4
5991 S 3500 W STE 400, ROY, UT, 84067-6702
✓ 9-Digit EDI 837 ZIP+4 (84067-6702)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1720442775 (ANNAMARIE IRENE BREEN, NP) 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
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1720442775 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | ANNAMARIE IRENE BREEN, NP |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner NUCC Code: 363L00000X (Nurse Practitioner) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 5991 S 3500 W STE 400, ROY, UT, 84067-6702 |
| Practice Telephone / Fax | Tel: (801) 845-4911 | Fax: (216) 279-8556 |
| Administrative Mailing Address | 5991 S 3500 W STE 400, ROY, UT, 84067-6702 |
| Enumeration & Last Sync | Enumerated: 2016-04-06 | CMS Record Updated: 2020-06-19 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363L00000X)
What Does Taxonomy Code 363L00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363L00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ANNAMARIE IRENE BREEN, NP)
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
- 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 |
|---|---|
363L00000X — Nurse PractitionerPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner | State: UT | License: 7313401-4405 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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