Individual provider Active NPI

Rocco Carl Conca, PA-C

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1639819402
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14158207-1206 Issued in UT
Practice address
1200 E 3900 S
Salt Lake City, UT 84124-1300
Phone
(801) 268-7111
NPI assigned
Mar 30, 2022
Last updated
Dec 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 14158207-1206 UT Primary
Surgical Physician Assistant 363AS0400X 14158207-1206 UT

Addresses

Primary practice location

1200 E 3900 S
Salt Lake City, UT 84124-1300

Mailing address

556 E 2100 S
Salt Lake City, UT 84106-3015
Phone (303) 815-2125

Other practice location 1

12000 E Big Cottonwood Canyon Rd
Brighton, UT 84121-9710
Phone (801) 533-2002

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
I20241002001545 UT Practitioner - Physician Assistant 2567993413 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14158207-1206UTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Integrated Care, LLC CurrentSince Oct 10, 2024 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Jan 1, 2025 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Jan 1, 2025 Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Physician Group of Utah Inc Past Accepting new patients

Locations

2690 N 600 W
Pleasant View, UT 84414
Phone (801) 786-7911

3451 W 5600 S
Roy, UT 84067
Phone (801) 896-5600

333 N 300 W
Salt Lake City, UT 84103
Phone (801) 463-7415

82 S 1100 E
Ste 103
Salt Lake Cty, UT 84102
Phone (801) 505-5370

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

1200 E 3900 S
Slc, UT 84124
Phone (801) 268-7111

2675 W Taylorsville Blvd
Taylorsville, UT 84129
Phone (801) 982-0050

Organizations & group practices 7

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": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1639819402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 E 2100 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063015",
            "telephone_number": "303-815-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241300",
            "telephone_number": "801-268-7111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12000 E Big Cottonwood Canyon Rd",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "UT",
            "postal_code": "841219710",
            "country_code": "US",
            "telephone_number": "801-533-2002",
            "fax_number": "801-323-9546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONCA",
        "first_name": "ROCCO",
        "middle_name": "CARL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "14158207-1206",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "UT",
            "license": "14158207-1206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.