Individual provider Active NPI

Marlon B Michel, MD MBA

  • Anesthesiology Physician
  • Salt Lake City, UT
National Provider Identifier
1578664892
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
5685713-1205 Issued in UT
Practice address
36 E Knightsbridge LN
Salt Lake City, UT 84103-2241
Phone
(702) 200-0005
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 5685713-1205 UT Primary
Anesthesiology Physician 207L00000X MD00044212 WA

Addresses

Primary practice location

36 E Knightsbridge LN
Salt Lake City, UT 84103-2241

Mailing address

36 E Knightsbridge LN
Salt Lake City, UT 84103-2241
Phone (702) 200-0005

Other identifiers 5

IdentifierTypeStateIssuer
2090168OtherUTUNITED HEALTHCARE
QM0000075886OtherUTALTIUS
1502954OtherUTUMWA
084958MedicaidAZ
122721100MedicaidWY

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5685713-1205UTMDAnesthesiology Physician
MD00044212WAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Idaho Surgery Center PLLC CurrentSince Mar 15, 2011 Accepting new patients
Mda PLLC Anesthesiology Current Accepting new patients
M2 Anesthesia, PLLC Anesthesiology CurrentSince Feb 23, 2025 Accepting new patients
MD Anesthesia PLLC Anesthesiology Current Accepting new patients
Picetti LTD Anesthesiology Past Accepting new patients
Mountain West Anesthesia LLC Anesthesiology PastSince Jan 1, 1998 Accepting new patients
Marlon Michel MD PC Anesthesiology Past Accepting new patients
Marlon Michel MD PC Anesthesiology Past Accepting new patients

Locations

8412 Myers Rd E
Ste 205
Bonney Lake, WA 98391
Phone (206) 605-5933

Organizations & group practices 8

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1578664892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 E KNIGHTSBRIDGE LN",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032241",
            "telephone_number": "702-200-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 E KNIGHTSBRIDGE LN",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032241",
            "telephone_number": "702-200-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHEL",
        "first_name": "MARLON",
        "middle_name": "B",
        "credential": "MD MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "5685713-1205",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00044212",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2090168",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "QM0000075886",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1502954",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084958",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122721100",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.