Mark J Cacciamani Family Practice
2374 Evergreen Ave, Salt Lake City, UT 84109-3006


Mark J Cacciamani is physician registered in the Centers for Medicare & Medicaid Services (CMS). The National Provider Identifier (NPI) of the National Plan and Provider Enumeration System (NPPES) is 1063500163. The unique individual professional ID assigned by Provider Enrollment, Chain, and Ownership System (PECOS) is 9537057773. The medical credential is MD. The primary specialty is FAMILY PRACTICE. The organization is MA BO INC. The address is 2374 Evergreen Ave, Salt Lake City, UT 84109-3006. The zip code is 84109.


Mark J Cacciamani · 2374 Evergreen Ave, Salt Lake City, UT 84109-3006

Nation Provider ID 1063500163
PAC ID by PECOS 9537057773
Professional Enrollment ID I20040309000328
Last Name CACCIAMANI
First Name MARK
Middle Name J
Gender M
Credential MD
Medical School Name GEORGETOWN UNIVERSITY OF MEDICINE
Graduation Year 1999
Primary Specialty FAMILY PRACTICE
Primary Specialty MA BO INC
Phone Number 8012722601
Group Practice PAC ID 1254399652
Number of Group Practice Members 5
Address 2374 EVERGREEN AVE
SALT LAKE CITY, UT 841093006
Claims Based Hospital Affiliation Claim Control Number (CCN): 460001
Legal Business Name: UTAH VALLEY HOSPITAL
Claims Based Hospital Affiliation Claim Control Number (CCN): 460023
Legal Business Name: AMERICAN FORK HOSPITAL
Claims Based Hospital Affiliation Claim Control Number (CCN): 460044
Legal Business Name: ALTA VIEW HOSPITAL
Claims Based Hospital Affiliation Claim Control Number (CCN): 460051
Legal Business Name: JORDAN VALLEY MEDICAL CENTER
Claims Based Hospital Affiliation Claim Control Number (CCN): 460006
Legal Business Name: LDS HOSPITAL
Professional accepts Medicare Assignment Y
Report Quality Measures Y
Participated in Million Hearts Y

Ma Bo Inc · Medicare Physician

Name Address Specialty
Sharon Strong 2374 Evergreen Ave, Salt Lake City, UT 84109-3006 FAMILY PRACTICE
Perrine Anderson 2374 Evergreen Ave, Salt Lake City, UT 84109-3006 NURSE PRACTITIONER
Sandra Jense 522 E 100, Salt Lake City, UT 84102-1905 NURSE PRACTITIONER
Ann Webb 522 E 100, Salt Lake City, UT 84102-1905 NURSE PRACTITIONER

Zip 84109 · Family Practice · Medicare Physician

Name Address Specialty
Wesley Lewis 2295 Foothill Dr, Salt Lake City, UT 84109-4000 FAMILY PRACTICE
Diana Grazulis 2295 Foothill Dr, Salt Lake City, UT 84109-4000 FAMILY PRACTICE
Susan Edwards 2295 Foothill Dr, Salt Lake City, UT 84109-4000 FAMILY PRACTICE
Alexander Clark 2295 Foothill Dr, Salt Lake City, UT 84109-4000 FAMILY PRACTICE
Shana Eborn 2295 Foothill Dr, Salt Lake City, UT 84109-4000 FAMILY PRACTICE
Sara Wells 2131 E 2100, Salt Lake City, UT 84109-1128 FAMILY PRACTICE
Ross Brunetti 2295 Foothill Dr, Salt Lake City, UT 84109-4000 FAMILY PRACTICE
Sharon Strong 2374 Evergreen Ave, Salt Lake City, UT 84109-3006 FAMILY PRACTICE
Shane Christensen 2295 Foothill Dr, Salt Lake City, UT 84109-4000 FAMILY PRACTICE

Zip 84109 · Medicare Physician

Name Address Specialty
Janice Nelson 2319 S Foothill Dr, Salt Lake City, UT 84109-5401 CLINICAL PSYCHOLOGIST
Ross Brunetti 2295 Foothill Dr, Salt Lake City, UT 84109-4000 FAMILY PRACTICE
Kent Smith 2295 S Foothill Dr, Salt Lake City, UT 84109-4000 GASTROENTEROLOGY
James Grant 2189 E 3300, Salt Lake City, UT 84109-2666 CHIROPRACTIC
Jan Magdalen 2071 E Ashton Cir, Salt Lake City, UT 84109-1103 CLINICAL SOCIAL WORKER
Stephen Morris 3167 E Louise Ave, Salt Lake City, UT 84109-2224 CLINICAL PSYCHOLOGIST
Sara Wells 2131 E 2100, Salt Lake City, UT 84109-1128 FAMILY PRACTICE
Shana Eborn 2295 Foothill Dr, Salt Lake City, UT 84109-4000 FAMILY PRACTICE
Sharon Strong 2374 Evergreen Ave, Salt Lake City, UT 84109-3006 FAMILY PRACTICE
Ryan Hemming 3257 E 3300, Salt Lake City, UT 84109-2246 OCCUPATIONAL THERAPY
Janna Mann 2645 E Parleys Way, Salt Lake City, UT 84109-1636 PHYSICAL THERAPY
Laura Nice 2645 E Parleys Way, Salt Lake City, UT 84109-1636 PHYSICAL THERAPY
Perrine Anderson 2374 Evergreen Ave, Salt Lake City, UT 84109-3006 NURSE PRACTITIONER
Jack Taylor 2295 Foothill Dr, Salt Lake City, UT 84109-4000 GENERAL PRACTICE
Erik Van Slooten 3424 S 2300, Salt Lake City, UT 84109-3022 CHIROPRACTIC
Susan Edwards 2295 Foothill Dr, Salt Lake City, UT 84109-4000 FAMILY PRACTICE
Donna Thompson 2295 S Foothill Dr, Salt Lake City, UT 84109-4000 NURSE PRACTITIONER
Patricia Deyoung 2319 S Foothill Dr, Salt Lake City, UT 84109-5403 CLINICAL SOCIAL WORKER
Umaprasanna Karnam 2295 S Foothill Dr, Salt Lake City, UT 84109-4000 GASTROENTEROLOGY
Ann Rauscher 2645 E Parleys Way, Salt Lake City, UT 84109-1636 PHYSICAL THERAPY