Brian Kowallis Gardner, DPM is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in Roosevelt, Utah. He graduated from medical school in 2005 and has 19 years of diverse experience with area of expertise as Podiatry. He is a member of the group practice Northeastern Utah Medical Group, Uintah Basin Medical Center and his current practice location is
210 W 300 N, Roosevelt, Utah. You can reach out to his office (for appointments etc.) via phone at
(435) 722-6163.
Brian Kowallis Gardner is licensed to practice in Utah (license number 6297901-0501) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1396943825.
Healthcare Provider's Profile
| Full Name | Brian Kowallis Gardner |
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| Gender | Male |
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| Speciality | Podiatry |
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| Experience | 19 Years |
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| Location | 210 W 300 N, Roosevelt, Utah |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Brian Kowallis Gardner graduated from medical school in 2005
NPI Data:
- NPI Number: 1396943825
- Provider Enumeration Date: 07/05/2007
- Last Update Date: 05/11/2017
Medicare PECOS Information:
- PECOS PAC ID: 6406921717
- Enrollment ID: I20080821000289
Medical Identifiers
Medical identifiers for Brian Kowallis Gardner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1396943825 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 6297901-0501 (Utah) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Northeastern Utah Medical Group | 2961496609 | 45 |
| Uintah Basin Medical Center | 0244131944 | 53 |
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. Brian Kowallis Gardner allows following entities to bill medicare on his behalf.
| Provider Name | Uintah Basin Medical Center |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1871556217
PECOS PAC ID: 0244131944
Enrollment ID: O20040226000948 |
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| Provider Name | Northeastern Utah Medical Group |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1982664199
PECOS PAC ID: 2961496609
Enrollment ID: O20040414000471 |
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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. Brian Kowallis Gardner 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 |
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Brian Kowallis Gardner, DPM
210 W 300 N,
Roosevelt, UT 84066-2336
Ph: (435) 722-6163 | Brian Kowallis Gardner, DPM
210 W 300 N,
Roosevelt, UT 84066-2336
Ph: (435) 722-6163 |
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