Organization Active NPI

Restoration Health Medical Group PLLC

Doing business as Restoration Health

  • Surgery Physician
  • Lehi, UT
National Provider Identifier
1316855794
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
RESTORATION HEALTH MEDICAL GROUP PLLC
Doing business as
Restoration Health
Practice address
394 W Main St
Ste 105
Lehi, UT 84043
Phone
(385) 606-0405
Fax
(385) 437-1562
NPI assigned
Aug 28, 2026
Last updated
Aug 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Authorized official

Name
Jacob Petrosky, MD
Title
Owner
Phone
(385) 606-0405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

394 W Main St
Ste 105
Lehi, UT 84043

Mailing address

299 S. Main St Ste 1300
#93543
Salt Lake City, UT 84111
Phone (385) 606-0405

Other names 1

  • Restoration Health Doing business as

National Provider Directory

National Provider Directory

Locations

394 W Main St
Ste 105
Lehi, UT 84043

NPI Registry JSON

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

{
    "created_epoch": "1787875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787875200000",
    "number": "1316855794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 S. MAIN ST STE 1300",
            "address_2": "#93543",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84111",
            "telephone_number": "385-606-0405",
            "fax_number": "385-437-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "394 W MAIN ST",
            "address_2": "STE 105",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "84043",
            "telephone_number": "385-606-0405",
            "fax_number": "385-437-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION HEALTH MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-28",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A",
        "authorized_official_last_name": "PETROSKY",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "385-606-0405",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restoration Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lehi, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.