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EVAN K. DAUGHERTY MD
NPI 1487117198
Internal Medicine in Salt Lake City, UT

Active since April 09, 2019PECOS EnrolledAccepts Medicare Assignment
30 N 1900 E RM 4C116, SALT LAKE CITY, UT 84132(801) 581-7606 Get Directions Write a Review

NPPES record last updated: August 13, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 13, 2020, Apr 9, 2019 (2 updates tracked since 2019).

About Evan K. Daugherty Md NPPES

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

EVAN K. DAUGHERTY MD (NPI 1487117198) is an individual internal medicine provider in Salt Lake City, Utah, licensed in Utah (11885540-1205) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS, is affiliated with Christus St Vincent Regional Medical Center, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1487117198
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameEVAN K. DAUGHERTYCredential: MD
Location Address30 N 1900 E RM 4C116Salt Lake City, UT 84132-0002
Mailing Address30 N 1900 E Rm 4c116Salt Lake City, UT 84132-0002 · (801) 581-7606
Phone(801) 581-7606
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateApril 9, 2019
Last NPPES UpdateAugust 13, 20202 updates tracked since enumeration
NPPES CertifiedAugust 13, 2020
✔ NPI 1487117198 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in UT · 11885540-1205
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
30 N 1900 E RM 4C116, Salt Lake City, UT 84132
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Evan K. Daugherty Md 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 ID5597183293
PECOS Enrollment IDI20250822001220
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.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Christus St Vincent Regional Medical Center

Acute Care Hospitals · Santa Fe, NM
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number320002
Location455 St Michael's DriveSanta Fe, NM 87505 · Santa Fe County
Emergency services Birthing friendly

Holy Cross Hospital A Div Of Taos Health Systems

Critical Access Hospitals · Taos, NM
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number321310
Location1397 Weimer RoadTaos, NM 87571 · Taos County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84132 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$125.70 typical visit price
range $54.34 – $166.03
Typical copayment $31.42 (range $13.58 – $41.50)
Most-billed visit code 99204
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

SIDDHARTH K. IYENGAR MD
Internal Medicine
30 N 1900 E RM 4C116
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7606
DAVID C. HAAK MD
Hospitalist
30 N 1900 E RM 4C116
SALT LAKE CITY, UT 84132
Salt Lake County (801) 585-3580
KELLEN A. SULLIVAN MD
Internal Medicine
30 N 1900 E RM 4C116
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7606
DR. CHARLES W. CUBBERLEY MD
Internal Medicine
30 N 1900 E RM 4C116
SALT LAKE CITY, UT 84132
Salt Lake County (801) 585-3580
ALICIA HSU BOWLES MD
Internal Medicine
30 N 1900 E RM 4C116
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7606
ANEES DAUD
Internal Medicine (Cardiovascular Disease)
30 N 1900 E RM 4C116, UNIVERSITY OF UTAH DEPARTMENT OF MEDICINE OFFICE OF EDU
SALT LAKE CITY, UT 84132
Salt Lake County (801) 585-0418
JAWAD S A ALMAJED MBBS
Internal Medicine
30 N 1900 E RM 4C116
SALT LAKE CITY, UT 84132
Salt Lake County (801) 585-3580
ELENA G. GIBSON MD
Internal Medicine
30 N 1900 E RM 4C116
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7606

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evan Daugherty's NPI number?

The NPI number for Evan Daugherty is 1487117198. It was assigned to this individual provider in the NPPES registry on April 9, 2019.

Where is Evan Daugherty located?

Evan Daugherty practices at 30 N 1900 E Rm 4c116, Salt Lake City, UT 84132. The listed phone number is (801) 581-7606.

What is Evan Daugherty's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Evan Daugherty enrolled in Medicare?

Yes. Evan Daugherty is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Evan Daugherty affiliated with any hospitals?

According to CMS data, Evan Daugherty is affiliated with Christus St Vincent Regional Medical Center and Holy Cross Hospital A Div Of Taos Health Systems.

When was this NPI record last updated?

The NPPES record for Evan Daugherty was last updated on August 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.