Ethan Breck Hall, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Spanish Fork, Utah. His current practice location is
819 E Market Place Dr, Spanish Fork, Utah. You can reach out to his office (for appointments etc.) via phone at
(385) 344-6800.
Ethan Breck Hall is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1538818448.
Physician's Profile
| Full Name | Ethan Breck Hall |
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| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 819 E Market Place Dr, Spanish Fork, Utah |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1538818448
- Provider Enumeration Date: 03/20/2022
- Last Update Date: 10/09/2025
Medicare PECOS Information:
- PECOS PAC ID: 5597118034
- Enrollment ID: I20240131002535
Medical Identifiers
Medical identifiers for Ethan Breck Hall such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1538818448 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207Q00000X | Family Medicine | 13547791-1204 (Utah) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ethan Breck Hall allows following entities to bill medicare on his behalf.
| Entity Name | Ihc Health Services Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1942325154 PECOS PAC ID: 1850209420 Enrollment ID: O20080610000303 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethan Breck Hall is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Ethan Breck Hall, DO 819 E Market Place Dr, Spanish Fork, UT 84660-1396 Ph: (385) 344-6800 | Ethan Breck Hall, DO 819 E Market Place Dr, Spanish Fork, UT 84660-1396 Ph: (385) 344-6800 |
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