Mark J Cacciamani (NPI# 1063500163, PAC ID# 9537057773) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1063500163 |
| PAC ID by PECOS | 9537057773 |
| Professional Enrollment ID | I20040309000328 |
| Full Name | Mark J Cacciamani |
| Organization Legal Name | MA BO INC |
| Address |
522 E 100 Salt Lake City UT 84102-1905 |
| Phone Number | 8014855055 |
| Gender | M |
| Credential | MD |
| Medical School | GEORGETOWN UNIVERSITY OF MEDICINE |
| Graduation Year | 1999 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 1254399652 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 460051 | JORDAN VALLEY MEDICAL CENTER |
| 460001 | UTAH VALLEY HOSPITAL |
| 460023 | AMERICAN FORK HOSPITAL |
| 460044 | ALTA VIEW HOSPITAL |
| 460041 | DAVIS HOSPITAL AND MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 522 E 100, Salt Lake City, UT 84102-1905 | 8014855055 | MA BO INC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | MA BO INC |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sharon A Strong | Family Practice | Ma Bo Inc | 2011 W 4700, Taylorsville, UT 84118-1107 |
| Sandra B Jense | Nurse Practitioner | Ma Bo Inc | 522 E 100, Salt Lake City, UT 84102-1905 |
| Edith A Shepherd | Nurse Practitioner | Ma Bo Inc | 522 E 100, Salt Lake City, UT 84102-1905 |
| Rita Helen Rutland | Nurse Practitioner | Ma Bo Inc | 522 E 100, Salt Lake City, UT 84102-1905 |
| Perrine J Anderson | Nurse Practitioner | Ma Bo Inc | 522 E 100, Salt Lake City, UT 84102-1905 |
| Trenaisa M Nay | Nurse Practitioner | Ma Bo Inc | 522 E 100, Salt Lake City, UT 84102-1905 |
| Ann E Webb | Nurse Practitioner | Ma Bo Inc | 522 E 100, Salt Lake City, UT 84102-1905 |
| Street Address |
522 E 100 |
| City | SALT LAKE CITY |
| State | UT |
| Zip | 84102-1905 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sandra B Jense | Nurse Practitioner | Ma Bo Inc | 522 E 100, Salt Lake City, UT 84102-1905 |
| Edith A Shepherd | Nurse Practitioner | Ma Bo Inc | 522 E 100, Salt Lake City, UT 84102-1905 |
| Rita Helen Rutland | Nurse Practitioner | Ma Bo Inc | 522 E 100, Salt Lake City, UT 84102-1905 |
| Perrine J Anderson | Nurse Practitioner | Ma Bo Inc | 522 E 100, Salt Lake City, UT 84102-1905 |
| Trenaisa M Nay | Nurse Practitioner | Ma Bo Inc | 522 E 100, Salt Lake City, UT 84102-1905 |
| Ann E Webb | Nurse Practitioner | Ma Bo Inc | 522 E 100, Salt Lake City, UT 84102-1905 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amy N De La Garza | Family Medicine | 77 S 700, Suite 220, Salt Lake City, UT 84102-1162 | |
| Charles Ty Nuttall | Clinical Social Worker | 699 E S Temple, Suite 300, Salt Lake City, UT 84102-1186 | |
| Darren F Groberg | Podiatry | Utah Podiatric Physicians and Surgeons Group LLC | 144 S 700, Salt Lake City, UT 84102-1357 |
| Daniel Preece | Podiatry | Utah Podiatric Physicians and Surgeons Group LLC | 144 S 700, Salt Lake City, UT 84102-1357 |
| Steven R Taylor | Otolaryngology | Intermountain Ear Nose and Throat Specialists LLC | 22 S 900, Salt Lake City, UT 84102-1394 |
| Kian Eftekhari | Ophthalmology | Intermountain Ear Nose and Throat Specialists LLC | 22 S 900, Salt Lake City, UT 84102-1394 |
| Balimar B Lindgren | Nurse Practitioner | Santibanez Aguirre PC | 165 S 1000, Salt Lake City, UT 84102-1402 |
| Edwin Awinda | Nurse Practitioner | Santibanez Aguirre PC | 165 S 1000, Salt Lake City, UT 84102-1402 |
| Bernard M Mutie | Nurse Practitioner | Santibanez Aguirre PC | 165 S 1000, Salt Lake City, UT 84102-1402 |
| Nathan Michael Hastings | Hospitalist | Santibanez Aguirre PC | 165 S 1000, Salt Lake City, UT 84102-1402 |
| Find all physicians in zip 84102 | |||
| City | SALT LAKE CITY |
| Zip Code | 84102 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | SALT LAKE CITY + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Mark J Cacciamani.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.