Individual provider Active NPI

Sayamuny Alex Rattanatay

  • Physician Assistant
  • South Jordan, UT
National Provider Identifier
1740970987
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10433 S Redwood Rd Ste 2
South Jordan, UT 84095-8502
Phone
(801) 260-1919
Fax
(801) 260-1441
NPI assigned
May 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 14195336-1206 UT
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

10433 S Redwood Rd Ste 2
South Jordan, UT 84095-8502

Mailing address

10433 S Redwood Rd Ste 2
South Jordan, UT 84095-8502
Phone (801) 260-1919

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250401003044 UT Practitioner - Physician Assistant 5991228892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
After Hours Medical LLC 30 clinicians

Practice addresses (Care Compare)

10433 S Redwood Rd
South Jordan, UT 84095-8502
Phone (801) 501-0500

1126 E Draper Pkwy
Draper, UT 84020-9095
Phone (801) 545-0600

7998 S 1300
Sandy, UT 84094-0744
Phone (801) 255-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
After Hours Medical LLC, Dba Medallus Medical CurrentSince Mar 12, 2025 Accepting new patients
After Hours Medical LLC, Dba Medallus Medical CurrentSince Mar 12, 2025 Accepting new patients

Locations

1126 E Draper Pkwy
Draper, UT 84020
Phone (801) 545-0600

10433 S Redwood Rd
#2
South Jordan, UT 84095
Phone (801) 260-1919

10433 S Redwood Rd
South Jordan, UT 84095
Phone (801) 260-1919

Organizations & group practices 3

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": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1740970987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10433 S REDWOOD RD STE 2",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958502",
            "telephone_number": "801-260-1919",
            "fax_number": "801-260-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10433 S REDWOOD RD STE 2",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958502",
            "telephone_number": "801-260-1919",
            "fax_number": "801-260-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATTANATAY",
        "first_name": "SAYAMUNY",
        "middle_name": "ALEX",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-10",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "14195336-1206",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

Verify at the official NPI Registry.