Individual provider Active NPI

Marco Antonio Rudas-Garcia, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Orem, UT
National Provider Identifier
1386413409
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
9819736-4405 Issued in UT
Practice address
1433 N 1200 W
Orem, UT 84057-2449
Phone
(801) 655-5450
Fax
(385) 225-9327
NPI assigned
Dec 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 9819736-4405 UT Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10020784 OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61536353 WA

Addresses

Primary practice location

1433 N 1200 W
Orem, UT 84057-2449

Mailing address

1433 N 1200 W
Orem, UT 84057-2449
Phone (801) 655-5450

Other practice location 1

1929 W 2295 S
Woods Cross, UT 84087-2600
Phone (385) 416-7071

Other names 1

  • Marco Rudas-Garcia Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, UT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241025003478 OR Practitioner - Nurse Practitioner 8123551314 Reassigns benefits to 1 organization
I20250721000174 UT Practitioner - Nurse Practitioner 8123551314 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jacobs Mental Health ServicesGroup PAC ID 0749721702, 6 clinicians

Practice addresses (Care Compare)

13568 SE 97TH Ave
Suite 202
Clackamas, OR 97015-6668
Phone (503) 694-3381

7533 S Ctr View CT
Suite 210
West Jordan, UT 84084-5527
Phone (503) 694-3381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10020784ORMDPsychiatric/Mental Health Nurse Practitioner
AP61536353WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meadowbrook Counseling of Utah LLC Psychiatric/Mental Health CurrentSince Jun 9, 2025 Accepting new patients
Jacobs Mental Health Services Psychiatric/Mental Health CurrentSince Aug 5, 2024 Accepting new patients
Benjamin Healthcare Past Accepting new patients
Jacobs MH of Washington Psychiatric/Mental Health PastSince Mar 24, 2025 Accepting new patients
Meadowbrook Counseling of Washington, LLC PastSince Sep 1, 2023 Accepting new patients

Locations

13568 SE 97th Ave
Ste 202
Clackamas, OR 97015
Phone (503) 694-3381

1133 N Main St
Ste 100
Layton, UT 84041
Phone (801) 546-4368

1447 N 1200 W
Orem, UT 84057
Phone (415) 770-4094

1433 N 1200 W
Orem, UT 84057
Phone (801) 210-1432

1471 N 1200 W
Orem, UT 84057
Phone (801) 310-3295

10408 S 1055 W
Ste 102
South Jordan, UT 84095

7533 S Center View Ct
Ste 210
West Jordan, UT 84084
Phone (435) 275-9381

22232 17th Ave SE
Ste 305
Bothell, WA 98021

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1386413409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1433 N 1200 W",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840572449",
            "telephone_number": "801-655-5450",
            "fax_number": "385-225-9327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 N 1200 W",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840572449",
            "telephone_number": "801-655-5450",
            "fax_number": "385-225-9327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1929 W 2295 S",
            "address_purpose": "LOCATION",
            "city": "Woods Cross",
            "state": "UT",
            "postal_code": "840872600",
            "country_code": "US",
            "telephone_number": "385-416-7071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDAS-GARCIA",
        "first_name": "MARCO",
        "middle_name": "ANTONIO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-29",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "9819736-4405",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10020784",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61536353",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCO",
            "last_name": "RUDAS-GARCIA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orem, UT

Sources for this page

Verify at the official NPI Registry.