Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kenneth Costa

Individual provider Physical Therapist · NPI 1649319096

Kenneth Costa is a Physical Therapist in Private Practice in Salt Lake City, Utah. Qualified in 1997, 29 years ago. Practices with Ihc Health Services Inc, a 3,947-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
29
Licensed in
UT
In the registry since
2007
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Practice location Address checks out

1952 Fort Union Blvd # 100
Salt Lake City, UT 84121-6877
Phone: (801) 942-3311
Fax: (801) 942-5955
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 6022536-2401 (UT)

Record details

NPI number1649319096
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 5, 2007
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Ihc Health Services Inc — 3947 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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