Individual provider Active NPI

Mackenzie Roof

  • Orthopaedic Surgery Physician
  • Salt Lake City, UT
National Provider Identifier
1427638667
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
14280148-1205 Issued in UT
Practice address
590 S Wakara Way RM A0058
Salt Lake City, UT 84108-1200
Phone
(801) 587-5457
NPI assigned
Apr 12, 2021
Sex
Female
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 14280148-1205 UT Primary

Addresses

Primary practice location

590 S Wakara Way RM A0058
Salt Lake City, UT 84108-1200

Mailing address

590 S Wakara Way RM A0058
Salt Lake City, UT 84108-1200
Phone (801) 587-5457

Other practice location 1

550 1st Ave
New York, NY 10016-6402
Phone (212) 263-5506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
New York University School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 299
Salt Lake City, UT 84110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14280148-1205UTMDOrthopaedic Surgery Physician

Interoperability endpoints

  • Direct secure messaging: mroof153765@nyumc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1427638667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 S WAKARA WAY RM A0058",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081200",
            "telephone_number": "801-587-5457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 S WAKARA WAY RM A0058",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081200",
            "telephone_number": "801-587-5457"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100166402",
            "country_code": "US",
            "telephone_number": "212-263-5506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROOF",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "UT",
            "license": "14280148-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.