DR. DAVID EDMAND RODEBACK (PHD) – Clinical Social Worker, NPI 1679746846
Clinical Social Worker
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. DAVID EDMAND RODEBACK (PHD)
1121 E 3900 S STE C230
SALT LAKE CITY, UT 841241297
Phone: (801) 266-0878
Type: Mailing
1818 Mueller Park Road
Bountiful, UT 84010
Phone: (801) 499-9042
Type: Location
100, 700 East, Salt Lake City, Salt Lake County, Utah, 84102, United States
SALT LAKE CITY, UT 841061494
Phone: (801) 269-0231
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2013-04-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130412000319 | I | Clinical Social Worker | UT | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hour | 64 | 16 | $0 |
| 90791 | Psychiatric diagnostic evaluation | 13 | 13 | $0 |
Insurance plans in this area (ZIP 84124)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | UT | |
| Radiation Oncology | UT | |
| - | UT | |
| Nurse Practitioner | UT | |
| Hematology/Oncology, Medical Oncology, Internal Medicine | CO | |
| Medical Oncology | UT | |
| Medical Oncology, Hematology | UT | |
| Medical Oncology, Internal Medicine | UT | |
| Radiation Oncology | UT | |
| H E M A T O L O G Y/ O N C O L O G Y | UT |
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