Individual provider Active NPI

Michael Caid Evans, PA-C

  • Physician Assistant
  • Layton, UT
National Provider Identifier
1790188910
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9159630-1206 Issued in UT
Practice address
2950 N Church St Ste 200
Layton, UT 84040-6590
Phone
(801) 771-7700
Fax
(801) 771-7799
NPI assigned
Oct 1, 2014
Last updated
Dec 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9159630-1206 UT Primary

Addresses

Primary practice location

2950 N Church St Ste 200
Layton, UT 84040-6590

Mailing address

PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3500

Other names 1

  • M Caid Evans Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141027002161 UT Practitioner - Physician Assistant 4587885090 Reassigns benefits to 2 organizations
I20150122001863 TX Practitioner - Physician Assistant 4587885090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Arizona College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians

Practice addresses (Care Compare)

1750 E 3100
Layton, UT 84040-2406
Phone (801) 773-4840

2121 N 1700
Layton, UT 84041-8803
Phone (801) 773-4840

425 S 100
Layton, UT 84041-5356
Phone (801) 773-4840

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9159630-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Memorial Clinic CurrentSince Mar 25, 2024 Accepting new patients
Tanner Memorial Clinic CurrentSince Mar 25, 2024 Accepting new patients
Rosebud Indian Health Service CurrentSince Nov 10, 2014 Accepting new patients
Tanner Memorial Clinic Past Accepting new patients
Rosenberg Cooley Metcalf LC Past Accepting new patients

Locations

1756 W Antelope Dr
Layton, UT 84041
Phone (801) 525-8726

425 S 100 W
Layton, UT 84041
Phone (801) 525-8726

3443 W 5600 S
Roy, UT 84067
Phone (801) 825-6400

Interoperability endpoints

  • Direct secure messaging: caid.evans.p1@direct.tannerclinic.nextgenshare.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1790188910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-475-3500",
            "fax_number": "801-475-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 N CHURCH ST STE 200",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840406590",
            "telephone_number": "801-771-7700",
            "fax_number": "801-771-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MICHAEL",
        "middle_name": "CAID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-01",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "9159630-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M CAID",
            "last_name": "EVANS",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.