NPIMap

Individual provider Active NPI

Michael Shaun Machen, M.D.

  • Orthopaedic Surgery Physician
  • Salt Lake City, UT
National Provider Identifier
1366418386
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
4918951-1205 Issued in UT
Practice address
100 Mario Capecchi Dr # 4550
Salt Lake City, UT 84113-1103
Phone
(801) 662-5600
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X L5031 TX
Orthopaedic Surgery Physician 207X00000X 4918951-1205 UT Primary

Addresses

Primary practice location

100 Mario Capecchi Dr # 4550
Salt Lake City, UT 84113-1103

Mailing address

PO Box 413026
Salt Lake City, UT 84141-3026
Phone (801) 213-3900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmachen574637@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141025000087 UT Practitioner - Orthopedic Surgery 2769654110 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L5031TXMDOrthopaedic Surgery Physician
4918951-1205UTMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Services CurrentSince Dec 21, 2019 Accepting new patients
Shriners Hospitals for Children CurrentSince Sep 11, 2023 Accepting new patients
Shriners Hospitals for Children CurrentSince Sep 11, 2023 Accepting new patients
Shriners Hospitals for Children Current Accepting new patients
University of Utah Pediatric Services CurrentSince Dec 21, 2019 Accepting new patients
University of Utah Pediatric Services Current Accepting new patients
Pediatric Orthopedic Associates Past Accepting new patients
Orthoppedic Practice Associates Past Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients
University of Utah Pediatric Services Past Accepting new patients

Locations

1275 E Fairfax Rd
Salt Lake City, UT 84103
Phone (801) 536-3500

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

100 N Mario Capecchi Dr
#4550
Slc, UT 84113
Phone (801) 662-5600

Interoperability endpoints

  • Direct secure messaging: mmachen574637@direct.med.utah.edu

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1366418386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413026",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841413026",
            "telephone_number": "801-213-3900",
            "fax_number": "801-662-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARIO CAPECCHI DR # 4550",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHEN",
        "first_name": "MICHAEL",
        "middle_name": "SHAUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "L5031",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "UT",
            "license": "4918951-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmachen574637@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.