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

NPI Status: Active since May 09, 2019

Contact Information

2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ
ZIP 85234
Phone: (602) 648-5444
Fax: (602) 772-3801

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  • Individual
  • Male
  • Years of Experience 7
  • Orthopaedic Surgery
  • Adult Reconstructive Orthopaedic Surgery
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About DALLYN UDALL

This page provides the complete NPI Profile along with additional information for Dallyn Udall, a provider established in Gilbert, Arizona with a medical specialization in Orthopaedic Surgery, focusing in adult reconstructive orthopaedic surgery and more than 7 years of experience. He graduated from At Still University Of Health Sciences, College Of Osteo Med, Kirksville in 2019. The healthcare provider is registered in the NPI registry with number 1164088605 assigned on May 2019. The practitioner's primary taxonomy code is 207XS0114X with license number 011544 (AZ). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI
1164088605
Provider Name
DALLYN PORTER UDALL DO
Gender
Male
Entity Type
Individual
Location Address
2940 E BANNER GATEWAY DR STE 200-250 GILBERT, AZ 85234
Location Phone
(602) 648-5444
Location Fax
(602) 772-3801
Mailing Address
PO BOX 80217 PHOENIX, AZ 85060
Mailing Phone
(602) 385-2115
Mailing Fax
(602) 772-3801
Medical School Name
AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduation Year
2019
Is Sole Proprietor?
No
Enumeration Date
05-09-2019
Last Update Date
05-02-2025
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Location Map

Secondary Locations

  • 10710 N Torrey Pines Rd
    LA Jolla, CA 92037
    (858) 554-7993

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery

Taxonomy Code
207XS0114X
Type
Allopathic & Osteopathic Physicians
License No.
011544
License State
AZ
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207X00000XAllopathic & Osteopathic Physicians

Orthopaedic Surgery

20A19340 (CA)
2207X00000XAllopathic & Osteopathic Physicians

Orthopaedic Surgery

011544 (AZ)
3207XS0114XAllopathic & Osteopathic Physicians

Orthopaedic Surgery
Adult Reconstructive Orthopaedic Surgery

20A19340 (CA)
4390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • AZ Blue AdvanceHealth Bronze Focus (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Gold Focus (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Silver Focus (4 Free PCP Visits) - HMO
  • AZ Blue EverydayHealth Prosano Gold ($0 Prosano Health Visits) - HMO
  • AZ Blue EverydayHealth Prosano Silver ($0 Prosano Health Visits) - HMO
  • AZ Blue Portfolio Bronze HSA Focus - HMO
  • AZ Blue StandardHealth Bronze Focus - HMO
  • AZ Blue StandardHealth Gold Focus - HMO
  • AZ Blue StandardHealth Silver Focus - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Dallyn Udall is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Dallyn Udall is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 3971975152

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20250409002284

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1164088605, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
4
Unchanged
Pos 5
0
Doubled → 0
Pos 6
8
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
6
Unchanged
Pos 9
0
Doubled → 0
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 0 → 0 8 → 16 → 7 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 2 + 4 + 0 + 8 + 1 + 6 + 6 + 0 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1164088605.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Physical Therapist
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Physician Assistant
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Physical Therapist
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Physical Therapist
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Physician Assistant
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Physician Assistant
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Physician Assistant (Surgical)
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Physician Assistant
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Physical Therapist
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Physical Therapist
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Physical Therapist
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Occupational Therapist (Hand)
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Orthopaedic Surgery
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Occupational Therapist
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Physician Assistant
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Physical Therapist
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Physical Therapist
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Physician Assistant
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Physical Therapist
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234
Physical Therapist
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 85234

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164088605, enumerated as an "individual" on May 09, 2019.

The provider is located at 2940 E BANNER GATEWAY DR STE 200-250 GILBERT, AZ 85234 and the phone number is (602) 648-5444.

Orthopaedic Surgery with taxonomy code 207XS0114X and a focus in Adult Reconstructive Orthopaedic Surgery.

The provider might be accepting Accepts: Blue Cross Blue Shield of Arizona. Please consult your insurance carrier or call the provider to verify.