Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

ANNABELLE WILCOX AMICK PA-C
NPI 1619639853
Physician Assistant in Salt Lake City, UT

Active since October 05, 2021PECOS EnrolledAccepts Medicare Assignment
73.56/100
CMS Quality Rating
295 S CHIPETA WAY, SALT LAKE CITY, UT 84108(801) 587-7689 Get Directions Write a Review

NPPES record last updated: July 6, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 6, 2026, Mar 4, 2024, Jun 20, 2023 and 2 more (5 updates tracked since 2021).

About Annabelle Wilcox Amick Pa-c NPPES

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

ANNABELLE WILCOX AMICK PA-C (NPI 1619639853) is an individual physician assistant in Salt Lake City, Utah, licensed in Utah (13335479-1206) and active in the NPI registry since October 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in Salt Lake City, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1619639853
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameANNABELLE WILCOX AMICKCredential: PA-C
Location Address295 S CHIPETA WAYSalt Lake City, UT 84108-1287
Mailing AddressPo Box 30180Salt Lake City, UT 84130-0180
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateOctober 5, 2021
Last NPPES UpdateJuly 6, 20265 updates tracked since enumeration
NPPES CertifiedJuly 6, 2026
NPI 1619639853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in UT · 13335479-1206
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 5530 (CT)
295 S CHIPETA WAY, Salt Lake City, UT 84108

Secondary Practice Location 1

Location 181 N Mario Capecchi DrSalt Lake City, UT 84113-1125 · Phone (801) 662-1000

Accepted Insurance

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

Annabelle Wilcox Amick Pa-c 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 ID1456745546
PECOS Enrollment IDI20231024003295
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84108 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

73.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality75.84
Promoting Interoperability74
Improvement Activities40
Cost51.43

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.

Dietitian, Registered (Nutrition, Metabolic)
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Dietitian, Registered (Nutrition, Metabolic)
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Pediatrics (Neonatal-Perinatal Medicine)
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Dietitian, Registered
295 S CHIPETA WAY, SUITE 248
SALT LAKE CITY, UT 84108
Nurse Practitioner (Pediatrics)
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Massage Therapist
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Massage Therapist
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Pediatrics
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1619639853, enumerated as an "individual" on October 05, 2021.

The provider is located at 295 S CHIPETA WAY SALT LAKE CITY, UT 84108 and the phone number is (801) 587-7689.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: BridgeSpan Health Company, Molina Healthcare,. Please consult your insurance carrier or call the provider to verify.