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

Stacy Probasco

Individual provider Physician Assistant · NPI 1730639543

Stacy Probasco is a Physician Assistant in Layton, Utah. Graduated from University of Utah School of Medicine in 2016, 10 years ago. Practices with Tanner Memorial Clinic, a 252-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
10
Trained at
University of Utah School of Medicine
Licensed in
UT
In the registry since
2016
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Practice location Address checks out

2121 N 1700 W
Layton, UT 84041-8803
Phone: (801) 773-4840
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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 5542435-1206 (UT)

Record details

NPI number1730639543
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 5, 2016
Last updated in NPPESOctober 5, 2016
Mailing addressPo Box 337, Layton, UT 84041-0337

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 2016 (10 years in practice)
Group practice Tanner Memorial Clinic — 252 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Layton