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

Spencer Mazorra Hansen, MD

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1174143200

Spencer Mazorra Hansen, MD is a Physical Medicine and Rehabilitation in Provo, Utah. Qualified in 2020, 6 years ago. Practices with Ihc Health Services Inc, a 3,947-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
6
Licensed in
UT
In the registry since
2020
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

395 W Cougar Blvd Ste 502
Provo, UT 84604-3323
Phone: (801) 357-8818
Fax: (801) 357-8817
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 13959664-1205 (UT)

Record details

NPI number1174143200
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 18, 2020
Last updated in NPPESMarch 14, 2025
Certification dateMarch 14, 2025
Mailing addressPo Box 27128, Salt Lake City, UT 84127-0128

Medicare enrollment

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

Medicare specialtyPHYSICAL MEDICINE AND REHABILITATION
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Ihc Health Services Inc — 3947 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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