Individual provider Active NPI

Robert J Cionni, M.D.

  • Ophthalmology Physician
  • Salt Lake City, UT
National Provider Identifier
1306833256
Registry record updated Jan 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
6429027-1205 Issued in UT
Practice address
755 E 3900 S
Salt Lake City, UT 84107-2105
Phone
(801) 266-2283
Fax
(801) 268-6151
NPI assigned
Oct 5, 2005
Last updated
Jan 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 6429027-1205 UT Primary

Addresses

Primary practice location

755 E 3900 S
Salt Lake City, UT 84107-2105

Mailing address

755 E 3900 S
Salt Lake City, UT 84107-2105
Phone (801) 266-2283

Other identifiers 6

IdentifierTypeStateIssuer
1306833256MedicaidUT
180026062OtherOHRAIL ROAD MEDICARE NUMBER
64864309MedicaidKY
0742165MedicaidOH
100004440MedicaidIN
000000021151OtherOHBCBS FACET

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
I20070411000253 UT Practitioner - Ophthalmology 9436055134 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6429027-1205UTMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Institute of Utah Inc Ophthalmology CurrentSince Mar 1, 2007 Accepting new patients

Locations

755 E 3900 S
Salt Lake Cty, UT 84107
Phone (801) 266-2283

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1306833256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 E 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072105",
            "telephone_number": "801-266-2283",
            "fax_number": "801-268-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 E 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072105",
            "telephone_number": "801-266-2283",
            "fax_number": "801-268-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIONNI",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "6429027-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306833256",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE NUMBER",
            "identifier": "180026062",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64864309",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0742165",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100004440",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FACET",
            "identifier": "000000021151",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.