Wasatch Surgical LLC
NPI 1053201525 · Surgery Physician · Bountiful, UT
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Wasatch Surgical LLC is a Surgery Physician organization in Bountiful, UT (NPI 1053201525).
Provider details
- NPI number
- 1053201525
- Entity type
- Organization
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mackenzie Goodwin, Owner(228) 273-9021
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Mackenzie Goodwin MD
Additional practice locations (1)
- 74 Kimballs LaneBldg 2, Suite 260Draper, UT 84020Phone: (228) 273-9021
Registry dates
- Enumerated
- 2025-07-07
- Last updated
- 2025-07-07
- Certified
- 2025-07-07
Frequently asked questions
- What is Wasatch Surgical LLC's NPI number?
- Wasatch Surgical LLC's National Provider Identifier (NPI) is 1053201525, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Wasatch Surgical LLC?
- Wasatch Surgical LLC is classified in the NPPES registry as Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Wasatch Surgical LLC located?
- Wasatch Surgical LLC's practice location on file with NPPES is 520 Medical Dr Ste 300, Bountiful, UT 84010-8925.
- What is Wasatch Surgical LLC's phone number?
- The practice phone number listed in the NPPES registry for Wasatch Surgical LLC is (228) 273-9021.
- Does Wasatch Surgical LLC accept Medicare?
- Wasatch Surgical LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Wasatch Surgical LLC?
- The authorized official listed on Wasatch Surgical LLC's NPPES record is Mackenzie Goodwin, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Wasatch Surgical LLC's NPI active?
- Yes — Wasatch Surgical LLC's NPI (1053201525) is active in the NPPES registry as of the last update on 2025-07-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.