Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dale Jerry Green, PA-C

Individual provider Physician Assistant · NPI 1861044117

Dale Jerry Green, PA-C is a Physician Assistant in Salt Lake City, Utah. Graduated from University of Utah School of Medicine in 2020, 6 years ago. Practices with University of Utah Adult Services, a 1,740-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
6
Trained at
University of Utah School of Medicine
Licensed in
UT
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

85 N Medical Dr
Salt Lake City, UT 84132-1428
Phone: (801) 213-8584
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 11918961-1206 (UT)

Record details

NPI number1861044117
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 16, 2019
Last updated in NPPESOctober 24, 2022
Certification dateOctober 24, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice University Of Utah Adult Services — 1740 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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