MARK J CACCIAMANI (MD) – Family Medicine Physician, NPI 1063500163

MARK J CACCIAMANI (MD) is a healthcare provider. based in Salt lake city, Utah. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 49426771205 (UT). The NPI Number for MARK J CACCIAMANI (MD) is 1063500163

Main info

Male
27 Years Of Experience
Accepts Medicare Assignment
Name
MARK J CACCIAMANI (MD)
NPI
1063500163
Phone
(801) 485-5055
Address
522 E 100 S
Enumeration Date
11 October 2006
Last Update Date
19 August 2024

Doctor Profile

Medical School Name
GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
8014855055
Graduation Year
1999 (27 years ago)
PAC ID
9537057773
Group Practice PAC ID
1254399652
Professional Enrollment ID
I20040309000328
Address ID
UT841113350SA466XX500X301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,136 FAMILY PRACTICE in UT

Provider Addresses for MARK J CACCIAMANI (MD)

  • 522 E 100 S

    SALT LAKE CITY, UT 841021905

    Phone: (801) 485-5055

    Fax: (801) 467-3296

    Type: Location

  • 466 E 500 S STE 200

    SALT LAKE CITY, UT 841113350

    Phone: (801) 485-5055

    Fax: (801) 467-3296

    Type: Location

  • 1556, Emerson Avenue, Wasatch Hollow, Salt Lake City, Salt Lake County, Utah, 84105, United States

    SALT LAKE CITY, UT 841052728

    Phone: (801) 865-9590

    Fax: (801) 467-3296

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 31 Open Payments records for all available years, with a total value of $860.

Total Amount is formed as General ($860) + Research ($0) + Ownership ($0) = $860.

Last reported payment date: 2024-12-14 • Largest payer in this snapshot: ABBVIE INC. ($826).

Total Amount

$860

General + Research + Ownership

Payments

31

Total payment records

General Amount

$860

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-14

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-04-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 4 Medicare enrollment records; no due dates published yet.

Enrollment records

4

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040309000328IFamily PracticeUTTBD
I20180815002622IFamily PracticeIDTBD
I20181016000905IFamily PracticeNYTBD
I20240401002762IFamily PracticeCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0179Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a21861$0
G0180Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and8064$0
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes4118$0
View full utilization report →

Insurance plans in this area (ZIP 84102)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1254399652View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to MARK J CACCIAMANI (MD)?
NPI 1063500163 is assigned to MARK J CACCIAMANI (MD) under the national enumeration system.
Does this profile mean MARK J CACCIAMANI (MD) is currently active?
Yes — MARK J CACCIAMANI (MD) appears active in the national provider directory.
What does MARK J CACCIAMANI (MD) treat or focus on?
Patients typically see MARK J CACCIAMANI (MD) under the specialty Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where does public data place MARK J CACCIAMANI (MD)?
The snapshot lists Salt Lake City, Utah for MARK J CACCIAMANI (MD); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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