Individual provider Active NPI

Alex Lynch, DO

  • Surgery Physician
  • Riverton, UT
National Provider Identifier
1043839129
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
14296903-1204 Issued in UT
Practice address
3723 W 12600 S Ste 270
Riverton, UT 84065-7296
Phone
(801) 285-4600
NPI assigned
Apr 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 346074 LA
Surgery Physician 208600000X 14296903-1204 UT Primary

Addresses

Primary practice location

3723 W 12600 S Ste 270
Riverton, UT 84065-7296

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

4201 Saint Antoine St Ste 9C
Detroit, MI 48201-2153
Phone (313) 577-5009

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20250804002378 LA Practitioner - General Surgery 3476976549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Administrators of the Tulane Educational FundGroup PAC ID 0446163760, 388 clinicians

Practice addresses (Care Compare)

4200 Houma Blvd
Metairie, LA 70006-2970
Phone (504) 503-4000

Hospital & facility affiliations

  • East Jefferson General Hospital Hospital, Metairie, LA, CCN 190176

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
346074LAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund CurrentSince Aug 1, 2025 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Aug 1, 2025 Accepting new patients

Locations

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

1101 Medical Center Blvd
Marrero, LA 70072
Phone (504) 347-5511

4720 S I 10 Service Rd W
Ste 501
Metairie, LA 70001
Phone (504) 456-6701

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

4700 S I 10 Svc Rd W
Metairie, LA 70001
Phone (504) 780-6453

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

1430 Tulane Ave
New Orleans, LA 70112
Phone (504) 585-6485

2000 Canal St
New Orleans, LA 70112
Phone (504) 702-2287

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 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": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1043839129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3723 W 12600 S STE 270",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657296",
            "telephone_number": "801-285-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Saint Antoine St Ste 9C",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012153",
            "country_code": "US",
            "telephone_number": "313-577-5009",
            "fax_number": "313-577-5310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "ALEX",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "346074",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "14296903-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

Verify at the official NPI Registry.