Individual provider Active NPI

Michael Dayton Delange, MD

  • Family Medicine Physician
  • Layton, UT
National Provider Identifier
1043390958
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13150993-1205 Issued in UT
Practice address
3225 W Gordon Ave Ste 1
Layton, UT 84041-5728
Phone
(801) 397-6150
Fax
(801) 397-6151
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A70358 CA
Family Medicine Physician 207Q00000X 13150993-1205 UT Primary

Addresses

Primary practice location

3225 W Gordon Ave Ste 1
Layton, UT 84041-5728

Mailing address

PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3500

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230303000720 UT Practitioner - Family Practice 3870489503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Columbia University College of Physicians and Surgeons, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ogden Clinic PCGroup PAC ID 9638078033, 104 clinicians

Practice addresses (Care Compare)

3225 W Gordon Ave
Suite 1
Layton, UT 84041-5728
Phone (801) 773-7232

Hospital & facility affiliations

  • Holy Cross Hospital-Davis Hospital, Layton, UT, CCN 460041
  • Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13150993-1205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ogden Clinic Specialty Services LLC Current Accepting new patients
Ogden Clinic PC Family Medicine CurrentSince Feb 1, 2023 Accepting new patients

Locations

3225 W Gordon Ave
Ste 1
Layton, UT 84041
Phone (801) 397-6150

5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100

1491 E Ridgeline Dr
South Ogden, UT 84405
Phone (317) 790-7550

6112 S Harrison
South Ogden, UT 84405
Phone (801) 475-3800

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

Organizations & group practices 2

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 2

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1043390958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-475-3500",
            "fax_number": "801-475-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 W GORDON AVE STE 1",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415728",
            "telephone_number": "801-397-6150",
            "fax_number": "801-397-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELANGE",
        "first_name": "MICHAEL",
        "middle_name": "DAYTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A70358",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "13150993-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.