Individual provider Active NPI

McKie Alan Delahunty, PA-C

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1003368283
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10119894-1206 Issued in UT
Practice address
4000 S 700 E Ste 10
Salt Lake City, UT 84107-2580
Phone
(801) 268-4141
NPI assigned
Nov 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10119894-1206 UT Primary

Addresses

Primary practice location

4000 S 700 E Ste 10
Salt Lake City, UT 84107-2580

Mailing address

4000 S 700 E Ste 10
Salt Lake City, UT 84107-2580
Phone (801) 268-4141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170131000456 UT Practitioner - Physician Assistant 3870875693 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT Professional Association ServicesGroup PAC ID 8921053349, 18 clinicians

Practice addresses (Care Compare)

4000 S 700
Suite 10
Salt Lake City, UT 84107-2580
Phone (801) 268-4141

491 N Main St
Tooele, UT 84074-1654
Phone (435) 882-6448

Hospital & facility affiliations

  • St Mark'S Hospital Hospital, Salt Lake City, UT, CCN 460047
  • Intermountain Medical Center Hospital, Murray, UT, CCN 460010
  • LDS Hospital Hospital, Salt Lake City, UT, CCN 460006
  • Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10119894-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
After Hours Medical LLC, Dba Medallus Medical CurrentSince Mar 1, 2018 Accepting new patients
After Hours Medical LLC, Dba Medallus Medical CurrentSince Mar 1, 2018 Accepting new patients

Locations

1126 E Draper Pkwy
Draper, UT 84020
Phone (801) 545-0600

10433 S Redwood Rd
South Jordan, UT 84095
Phone (801) 260-1919

Interoperability endpoints

  • Direct secure messaging: mdelahunty@entslc.emadirect.md

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1003368283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 S 700 E STE 10",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072580",
            "telephone_number": "801-268-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 S 700 E STE 10",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072580",
            "telephone_number": "801-268-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAHUNTY",
        "first_name": "MCKIE",
        "middle_name": "ALAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-03",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "10119894-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.