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Staci Janae Brandenburg, PA-C

NPI 1487279626ActiveIndividual· Physician Assistant, Medical· West Valley City, UT

Physician Assistant, Medical (PA-C) in West Valley City, Utah, licensed in UT, with an NPI issued in June 2020. Mostly services rather than prescriptions: Medicare paid $697.14 for 11 patients in 2024, with only 20 Part D claims.

Overview

NPI1487279626
StatusActive
Entity typeIndividual
CredentialPA-C
Sole proprietorNo
NPI issuedJun 13, 2020
Last updated in NPPESOct 14, 2024
Certified by providerOct 14, 2024

Specialties and licenses

TaxonomyCodeLicenseState
Physician Assistant, Medical Primary363AM0700X12602904-8906UT
Physician Assistant363A00000X12602904-8906UT
Student in an Organized Health Care Education/Training Program390200000X—UT

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026
Accepts assignmentYes (participating)

Medicare services in 2024

Medicare patients11
Services billed18 across 6 procedure codes
Paid by Medicare$697.14

Part D prescriptions in 2024

Prescriptions (claims)20 · 20 30-day fills
Patients16
Total drug cost$187.03
Generic share100% of claims

Medicare sources and data years

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

Other Physician Assistant, Medical providers in West Valley City

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