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ALEX H. SHACKLETTE MD
NPI 1700440252
Pathology - Molecular Genetic Pathology in Salt Lake City, UT

Active since April 30, 2019PECOS Enrolled
ECCLES INSTITUTE OF HUMAN GENETICS: 15 N MEDICAL DR RM, SALT LAKE CITY, UT 84112(801) 581-2121 Get Directions Write a Review

NPPES record last updated: March 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 11, 2025, May 6, 2021, Apr 5, 2021 and 2 more (5 updates tracked since 2019).

About Alex H. Shacklette Md NPPES

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

ALEX H. SHACKLETTE MD (NPI 1700440252) is an individual molecular genetic pathology provider in Salt Lake City, Utah, licensed in Utah (14188290-1205) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS and maintains a secondary practice location in Indianapolis.

NPPES Registry Identity

NPI1700440252
Entity TypeIndividualMale
Primary Taxonomy207ZP0007X
Provider Legal NameALEX H. SHACKLETTECredential: MD
Location AddressECCLES INSTITUTE OF HUMAN GENETICS: 15 N MEDICAL DR RMSalt Lake City, UT 84112-4108
Mailing AddressEccles Institute Of Human Genetics: 15 N Medical Dr RmSalt Lake City, UT 84112-4108 · (801) 581-2121
Phone(801) 581-2121
Sole ProprietorNo
Enumeration DateApril 30, 2019
Last NPPES UpdateMarch 11, 20255 updates tracked since enumeration
NPPES CertifiedMarch 7, 2025
✔ NPI 1700440252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPathology · Molecular Genetic PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0007X
License✔ Licensed in UT · 14188290-1205
Definition
A molecular genetic pathologist is expert in the principles, theory and technologies of molecular biology and molecular genetics. This expertise is used to make or confirm diagnoses of Mendelian genetic disorders, disorders of human development, infectious diseases and malignancies, and to assess the natural history of those disorders. A molecular genetic pathologist provides information about gene structure, function and alteration and applies laboratory techniques for diagnosis, treatment and prognosis for individuals with related disorders.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
ECCLES INSTITUTE OF HUMAN GENETICS: 15 N MEDICAL DR RM, Salt Lake City, UT 84112
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Secondary Practice Location 1

Location 1350 W 11th St Rm 4083Indianapolis, IN 46202-4108 · Phone (317) 491-6000

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alex H. Shacklette Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 84112 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 3

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

PATRICK G. HUSSEY DO
Pathology (Anatomic Pathology)
ECCLES INSTITUTE OF HUMAN GENETICS: 15 N MEDICAL DR RM
SALT LAKE CITY, UT 84112
Salt Lake County (801) 581-2121
DR. DAVID JOSEPH COOK MD
Pathology (Neuropathology)
ECCLES INSTITUTE OF HUMAN GENETICS: 15 N MEDICAL DR RM
SALT LAKE CITY, UT 84112
Salt Lake County (801) 581-2121
KAILEIGH M. BINGHAM ABUJASEN MD
Pathology (Anatomic Pathology & Clinical Pathology)
ECCLES INSTITUTE OF HUMAN GENETICS: 15 N MEDICAL DR RM
SALT LAKE CITY, UT 84112
Salt Lake County (801) 581-2121

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 Alex Shacklette's NPI number?

The NPI number for Alex Shacklette is 1700440252. It was assigned to this individual provider in the NPPES registry on April 30, 2019.

Where is Alex Shacklette located?

Alex Shacklette practices at Eccles Institute Of Human Genetics: 15 N Medical Dr Rm, Salt Lake City, UT 84112. The listed phone number is (801) 581-2121.

What is Alex Shacklette's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Molecular Genetic Pathology, with taxonomy code 207ZP0007X.

Is Alex Shacklette enrolled in Medicare?

Yes. Alex Shacklette is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Alex Shacklette was last updated on March 11, 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.