DALLYN PORTER UDALL DO
NPI 1164088605
Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery in Gilbert, AZ

Q: What is Dallyn Udall's NPI number?

The NPI number for Dallyn Udall is 1164088605. It was assigned to this individual provider in the NPPES registry on May 9, 2019.

Q: What is Dallyn Udall's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Adult Reconstructive Orthopaedic Surgery, with taxonomy code 207XS0114X.

Q: When was this NPI record last updated?

The NPPES record for Dallyn Udall was last updated on May 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 09, 2019PECOS EnrolledAccepts Medicare Assignment

2940 E BANNER GATEWAY DR STE 200-250, GILBERT, AZ 85234(602) 648-5444(602) 772-3801 Get Directions Write a Review

NPPES record last updated: May 2, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 24, 2024, Feb 3, 2023, May 9, 2019 (3 updates tracked since 2019).

On this page

About Dallyn Porter Udall Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DALLYN PORTER UDALL DO (NPI 1164088605) is an individual adult reconstructive orthopaedic surgery provider in Gilbert, Arizona, licensed in Arizona (011544) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS, maintains a secondary practice location in La Jolla, and is a graduate of At Still University Of Health Sciences, College Of Osteo Med, Kirksville (2019).

NPPES Registry Identity

NPI1164088605

Entity TypeIndividualMale

Primary Taxonomy207XS0114X

Provider Legal NameDALLYN PORTER UDALLCredential: DO

Location Address2940 E BANNER GATEWAY DR STE 200-250Gilbert, AZ 85234-2168

Mailing AddressPo Box 80217Phoenix, AZ 85060-0217 · (602) 385-2115 · Fax (480) 418-3323

Phone(602) 648-5444

Fax(602) 772-3801

Sole ProprietorNo

Medical School CMSAt Still University Of Health Sciences, College Of Osteo Med, KirksvilleGraduated 2019

Enumeration DateMay 9, 2019

Last NPPES UpdateMay 2, 20253 updates tracked since enumeration

NPPES CertifiedMay 2, 2025

✔ NPI 1164088605 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOrthopaedic Surgery · Adult Reconstructive Orthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207XS0114X

Licenses✔ Licensed in AZ · 011544✔ Licensed in CA · 20A19340

Definition

Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures.

Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License 20A19340 (CA), 011544 (AZ)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2940 E BANNER GATEWAY DR STE 200-250, Gilbert, AZ 85234

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Secondary Practice Location 1

Location 110710 N Torrey Pines RdLA Jolla, CA 92037-1035 · Phone (858) 554-7993

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc, Oscar Health Plan, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dallyn Porter Udall Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971975152

PECOS Enrollment IDI20250409002284

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Dallyn Udall reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Orthopedic Specialists Of North America PLLC

Same address

Orthopaedic Surgery

2940 E BANNER GATEWAY DR STE 200-250
Gilbert, AZ 85234

Reassigned Medicare billing, Arizona enrollment
330 clinicians in this Medicare group

NPI 1588986301 (480) 964-2908

Southern California Permanente Medical Group

302 mi

Health Maintenance Organization

3527 W FLORIDA AVE
Hemet, CA 92545

Reassigned Medicare billing, California enrollment
5,228 clinicians in this Medicare group

NPI 1013433465 (877) 608-0044

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

57 services56 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

46 services46 patients

Replacement of thigh bone and hip joint with prosthesis 27130

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

18 services18 patients

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CLAY DANIEL SHORTER PA

Physician Assistant