Justin Alan Illum
NPI 1265174452ActiveIndividual· Nurse Practitioner, Family· Midvale, UT
Nurse Practitioner, Family with University of Utah Adult Services, practicing in Midvale, Utah. Medicare paid $9,701 for services to 41 patients in 2024. Lists University of Utah Hospital and Clinics as a hospital affiliation.
Overview
| NPI | 1265174452 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Apr 8, 2022 |
| Last updated in NPPES | Dec 8, 2024 |
| Certified by provider | Dec 8, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | 10386297-4405 | UT |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (UT) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 41 |
|---|---|
| Services billed | 149 across 4 procedure codes |
| Paid by Medicare | $9,701 |
Education and affiliations
| Graduation year | 2023 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Medical group
- University of Utah Adult ServicesFarmington, UT · 1,788 clinicians
Hospital affiliation
- University of Utah Hospital and ClinicsSalt Lake City, UT
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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