Individual provider Active NPI

Michael Koniuch

  • Physical Medicine & Rehabilitation Physician
  • Salt Lake City, UT
National Provider Identifier
1225394612
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
97078441205 Issued in UT
Practice address
8074 South 1300 East
Healthsouth Rehabilitation Hospital
Salt Lake City, UT 84124
Phone
(801) 561-3400
NPI assigned
Apr 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 97078441205 UT Primary

Addresses

Primary practice location

8074 South 1300 East
Healthsouth Rehabilitation Hospital
Salt Lake City, UT 84124

Mailing address

8074 South 1300 East
Healthsouth Rehabilitation Hospital
Salt Lake City, UT 84124
Phone (248) 444-6752

Other practice location 1

14839 S Canyon Point Road
Draper, UT 84020-1489
Phone (385) 414-2158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160715000729 UT Practitioner - Physical Medicine and Rehabilitation 1759606049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Wayne State University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redrockrehab PLLCGroup PAC ID 8628514890, 9 clinicians

Practice addresses (Care Compare)

8074 S 1300
Sandy, UT 84094-0743
Phone (801) 561-3400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
97078441205UTMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Koniuch MD CurrentSince Dec 22, 2016 Accepting new patients
Redrockrehab PLLC Physical Medicine & Rehabilitation CurrentSince Jul 1, 2024 Accepting new patients
Forward Medical PC PastSince Mar 20, 2025 Accepting new patients

Locations

560 W 465 N
Ste 604
Providence, UT 84332
Phone (435) 753-1600

8074 S 1300 E
Sandy, UT 84094
Phone (801) 561-3400

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1225394612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8074 SOUTH 1300 EAST",
            "address_2": "HEALTHSOUTH REHABILITATION HOSPITAL",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84124",
            "telephone_number": "248-444-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8074 SOUTH 1300 EAST",
            "address_2": "HEALTHSOUTH REHABILITATION HOSPITAL",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84124",
            "telephone_number": "801-561-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14839 S Canyon Point Road",
            "address_purpose": "LOCATION",
            "city": "Draper",
            "state": "UT",
            "postal_code": "840201489",
            "country_code": "US",
            "telephone_number": "385-414-2158",
            "fax_number": "888-823-5887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONIUCH",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "UT",
            "license": "97078441205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.