Individual provider Active NPI

Jacob Rada, DPT

  • Physical Therapist
  • Salt Lake City, UT
National Provider Identifier
1780365239
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13462088-2401 Issued in UT
Practice address
324 E 10TH Ave
Salt Lake City, UT 84103-2853
Phone
(801) 408-5735
Fax
(801) 408-1659
NPI assigned
Jul 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13462088-2401 UT Primary

Addresses

Primary practice location

324 E 10TH Ave
Salt Lake City, UT 84103-2853

Mailing address

PO Box 25537
Salt Lake City, UT 84125-0537

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240115001651 UT Practitioner - Physical Therapist in Private Practice 9537511514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Minnesota Medical School, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

324 E 10TH Ave
Suite 100
Salt Lake City, UT 84103-2870
Phone (801) 408-5735

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13462088-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Dec 3, 2023 Accepting new patients
Ihc Health Services Inc Physical Therapist CurrentSince Dec 3, 2023 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

5171 S Cottonwood St
Ste 900
Salt Lake City, UT 84107
Phone (801) 507-2050

324 Tenth Ave
Ste 100
Slc, UT 84103
Phone (801) 408-5735

324 Tenth Ave
Slc, UT 84103
Phone (801) 408-5735

2655 W 9000 S
West Jordan, UT 84088
Phone (801) 256-6343

5373 W Lake Park Blvd
West Valley City, UT 84120
Phone (801) 902-7940

Organizations & group practices 3

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": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1780365239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25537",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E 10TH AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032853",
            "telephone_number": "801-408-5735",
            "fax_number": "801-408-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADA",
        "first_name": "JACOB",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-27",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "13462088-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.