Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mark Boyack, NP

Individual provider Nurse Practitioner · NPI 1750323986

Mark Boyack, NP is a Nurse Practitioner in Provo, Utah. Qualified in 2001, 25 years ago. Practices with Revere Health PC, a 410-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
25
Licensed in
UT
In the registry since
2006
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

1055 N 500 W Ste 222
Provo, UT 84604-3305
Phone: (801) 377-4623
Fax: (801) 377-6832
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 279656-4405 (UT)

Record details

NPI number1750323986
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedJune 12, 2006
Last updated in NPPESNovember 27, 2023
Certification dateAugust 25, 2020
Mailing address1055 N 500 W, Credentialing Department, Provo, UT 84604-3305

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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