David Edmand Rodeback, PHD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

138978-3501 Issued in UT

Practice address

3838 S 700 E Ste 100
Salt Lake City, UT 84106-1494

Phone

(801) 269-0231

NPI assigned

Apr 9, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

86.89 of 100Reported as group

Quality

77.34

Promoting interoperability

90

Improvement activities

40

Cost

77.57

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Utah Cancer Specialists PC

  • Medical Oncology Physician
  • Salt Lake City, UT
  • NPI 1619925369
  Medicare reassignment NPD
• Road Back LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Bountiful, UT
  • NPI 1598339905
  NPD (past)
• Utah Cancer Specialists PC

  • Non-Pharmacy Dispensing Site
  • Salt Lake City, UT
  • NPI 1912058942
  NPD (past)

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1679746846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 E 3900 S STE C230",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241297",
            "telephone_number": "801-266-0878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 S 700 E STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061494",
            "telephone_number": "801-269-0231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1818 Mueller Park Road",
            "address_purpose": "LOCATION",
            "city": "Bountiful",
            "state": "UT",
            "postal_code": "84010",
            "country_code": "US",
            "telephone_number": "801-499-9042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODEBACK",
        "first_name": "DAVID",
        "middle_name": "EDMAND",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-09",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "138978 3501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "138978-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rocky Mountain Retina Consultants
• Rocky Mountain Therapy Services LLC
• Rocky MTN Eye Care Associates LC
• Aylin Rachel Rodan, M.D.
• Jordan T. Rode, MD
• Heather Sahar Rodef
• Crystal Ann Roderick
• Claire Rodgers, OTR/L
• George M Rodgers, M.D.
• Lauren Rodgers

• Clinical Social Worker in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.