Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1154179844 Individual Practitioner Male Practitioner

Ethan Mark Nielsen , PA

Physician Assistant • Provo, UT

Professional Overview & Biography Verified Profile Summary

Ethan Nielsen, PA is a certified Physician Assistant practicing in Provo, UT. With approximately 1 years of clinical experience since completing medical education in 2025, Ethan Nielsen delivers high-quality medical care to the local community at 395 W BULLDOG BLVD.

Ethan Nielsen does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

395 W Bulldog Blvd

Provo, UT 846043311

Telephone 8013577081
Associated Practice Facility / Clinic
🏢 Ihc Health Services Inc Facility NPI 1427515170

Medicare Profile & Education

Medical School

Other

Graduation Year

2025

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Provo, UT

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
1 Yrs -9.1 yrs vs City Avg
City Avg: 10.1 Yrs
State Avg: 12.1 Yrs
Regional Practice Density
147 Specialists

Practicing in Provo, UT (1904 Statewide)

Telehealth Adoption Rate
19.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Nielsen (1 Years) 1 Yrs
Provo Specialty Average (10.1 Years) 10.1 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-11-21
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License UT 14245351-1206

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant - Medical

NUCC Taxonomy Code: 363AM0700X

State License UT 14245351-1206

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

31 Associated Practitioners
James Arregui , PA-C

Physician Assistant

NPI 1023407848

Physician Assistant (Certified)

Mark Loveless , PA-C

Physician Assistant

NPI 1063427904

Physician Assistant (Certified)

Dr. James Dane , MD

Thoracic Surgery (Cardiothoracic Vascular Surgery)

NPI 1083629828

Doctor of Medicine (M.D.)

Shay Harding

Nurse Practitioner - Family

NPI 1134887821
Kaylan Olsen , NP

Nurse Practitioner

NPI 1184431116

Nurse Practitioner

Dr. Hussein Daoud , MD

Internal Medicine - Cardiovascular Disease

NPI 1194246736

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location November 21, 2025

Registered at 395 W BULLDOG BLVD, PROVO, UT 846043311 (Tel: 8013577081)

📍
Updated Business Mailing Address November 21, 2025

Registered at PO BOX 27128, SALT LAKE CITY, UT 841270128

👤
Provider Name / Credentials Updated November 21, 2025

Recorded as ETHAN NIELSEN, PA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 21, 2025

Physician Assistant (License #14245351-1206 in UT)

NPI Profile Active May 08, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location May 08, 2024

Registered at 932 S 1520 W, OREM, UT 840595881 (Tel: 8019951704)

📍
Updated Business Mailing Address May 08, 2024

Registered at 932 S 1520 W, OREM, UT 840595881 (Tel: 8019951704)

👤
Provider Name / Credentials Updated May 08, 2024

Recorded as ETHAN NIELSEN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 08, 2024

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 08, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1154179844
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 08, 2024
Last Update: November 21, 2025
Sole Proprietor: No

Mailing Address

Po Box 27128

Salt Lake City, UT 841270128

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.