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ANNAMICHELLE KAY PACK PA-C
NPI 1619790672
Physician Assistant in Salt Lake City, UT

Active since November 06, 2024PECOS EnrolledAccepts Medicare Assignment
50 N MEDICAL DR # LEVEL1, SALT LAKE CITY, UT 84132(801) 585-7676 Get Directions Write a Review

NPPES record last updated: December 9, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 9, 2025, Nov 6, 2024 (2 updates tracked since 2024).

About Annamichelle Kay Pack Pa-c NPPES

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

ANNAMICHELLE KAY PACK PA-C (NPI 1619790672) is an individual physician assistant in Salt Lake City, Utah, licensed in Utah (14164525-1206) and active in the NPI registry since November 2024. She is enrolled in Medicare PECOS, is affiliated with University Of Utah Hospitals And Clinics, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1619790672
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameANNAMICHELLE KAY PACKCredential: PA-C
Location Address50 N MEDICAL DR # LEVEL1Salt Lake City, UT 84132-0001
Mailing Address50 N Medical Dr # Level1Salt Lake City, UT 84132-0001 · (801) 585-7676
Phone(801) 585-7676
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateNovember 6, 2024
Last NPPES UpdateDecember 9, 20252 updates tracked since enumeration
NPPES CertifiedDecember 9, 2025
✔ NPI 1619790672 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in UT · 14164525-1206
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.
50 N MEDICAL DR # LEVEL1, Salt Lake City, UT 84132
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.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

Annamichelle Kay Pack 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 ID7911435722
PECOS Enrollment IDI20250107003454
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

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

University Of Utah Hospitals And Clinics

Acute Care Hospitals · Salt Lake City, UT
5/5 CMS rating
OwnershipGovernment - State
CMS Certification Number460009
Location50 North Medical DriveSalt Lake City, UT 84132 · Salt Lake 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
$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.

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 Annamichelle Pack's NPI number?

The NPI number for Annamichelle Pack is 1619790672. It was assigned to this individual provider in the NPPES registry on November 6, 2024.

Where is Annamichelle Pack located?

Annamichelle Pack practices at 50 N Medical Dr # Level1, Salt Lake City, UT 84132. The listed phone number is (801) 585-7676.

What is Annamichelle Pack's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Annamichelle Pack enrolled in Medicare?

Yes. Annamichelle Pack 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.

What insurance does Annamichelle Pack accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Annamichelle Pack as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Annamichelle Pack affiliated with any hospitals?

According to CMS data, Annamichelle Pack is affiliated with University Of Utah Hospitals And Clinics.

When was this NPI record last updated?

The NPPES record for Annamichelle Pack was last updated on December 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.