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

Individual provider Family Medicine Physician · NPI 1063500163

Mark J Cacciamani, MD is a Family Practice in Salt Lake City, Utah. Graduated from Georgetown University School of Medicine in 1999, 27 years ago. Practices with MA Bo Inc, a 5-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
27
Trained at
Georgetown University School of Medicine
Licensed in
UT
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

466 E 500 S Ste 200
Salt Lake City, UT 84111-3350
Phone: (801) 485-5055
Fax: (801) 467-3296
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 49426771205 (UT)

Record details

NPI number1063500163
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 11, 2006
Last updated in NPPESAugust 19, 2024
Certification dateAugust 19, 2024

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolGEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduated 1999 (27 years in practice)
Group practice Ma Bo Inc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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