Individual provider Active NPI

Salvatore Rossano

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1598380628
Registry record updated Feb 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13754687-1206 Issued in UT
Practice address
117 W 400 S
Salt Lake City, UT 84101-1916
Phone
(801) 428-4257
NPI assigned
Jun 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 13754687-1206 UT Primary

Addresses

Primary practice location

117 W 400 S
Salt Lake City, UT 84101-1916

Mailing address

117 W 400 S
Salt Lake City, UT 84101-1916
Phone (801) 428-4257

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250226001954 UT Practitioner - Physician Assistant 3779003363 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1525 W 2100
Salt Lake City, UT 84119-1407
Phone (801) 213-9900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
13754687-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Odyssey House Inc Family Medicine CurrentSince Feb 5, 2025 Accepting new patients
University of Utah Community Physicians Group CurrentSince Jan 31, 2026 Accepting new patients
University of Utah Community Physicians Group Family Medicine CurrentSince Jan 31, 2026 Accepting new patients
Odyssey House Corp Past Accepting new patients

Locations

1525 W 2100 S
Salt Lake City, UT 84119
Phone (801) 213-8841

117 W 400 S
Slc, UT 84101
Phone (385) 200-0110

340 E 100 S
Slc, UT 84111
Phone (801) 322-3397

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.

Hospital & facility affiliations 3

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": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738454400000",
    "number": "1598380628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W 400 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841011916",
            "telephone_number": "801-428-4257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W 400 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841011916",
            "telephone_number": "801-428-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSANO",
        "first_name": "SALVATORE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-15",
        "last_updated": "2025-02-02",
        "certification_date": "2025-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "13754687-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.