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

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.

See every abbreviation used in this directory →

Practice location Address checks out

85 N Medical Dr
Salt Lake City, UT 84132-1428
Phone: (801) 213-8584
Show map & directions

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

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at University of Utah Adult Services

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 1740 clinicians in the practice; 12 are shown here.

Other providers in Salt Lake City