Mackenzie Kelly, MD

Primary specialty

Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X

License

14210189-1205 Issued in UT

Practice address

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

Phone

(801) 581-2121

NPI assigned

Mar 27, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Orthopedic Surgery

Education

Oregon Health Sciences University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009
• Holy Cross Hospital - Salt Lake Hospital, Salt Lake City, UT, CCN 460003

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkelly755046@direct.med.utah.edu

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.

• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment Care Compare group NPD
• University of Utah Adult Services

  • Vascular & Interventional Radiology Physician
  • Salt Lake City, UT
  • NPI 1457755258
  NPD
• University of Utah Adult Services

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• Bronson Lakeview Hospital

  • Internal Medicine Physician
  • Paw Paw, MI
  • NPI 1235131137

  Surgery

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1043915523
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1487734976
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1588656870
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1699889576
  Care Compare affiliation

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1942761580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 S WAKARA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081200",
            "telephone_number": "801-581-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 S WAKARA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081200",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_purpose": "LOCATION",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393098",
            "country_code": "US",
            "telephone_number": "503-494-8211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MACKENZIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "PG198843",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "UT",
            "license": "14210189-1205",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125.073820",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkelly755046@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth A. Kelly, M.D.
• Heather Margaret Kelly
• Jamie Kelly
• Jamie Kelly, OTR/L
• Kun Mao Kelly
• Mark Kelly
• Michael Patrick Kelly, RPH. MBA
• Rowan H. Kelner, MD
• Travis Lance Kelner, PA-C
• Diana Kelsch

• Adult Reconstructive Orthopaedic Surgery Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Adult Reconstructive Orthopaedic Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.