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

Tracy R Syddall, PA-C

Individual provider Medical Physician Assistant · NPI 1205070091

Tracy R Syddall, PA-C is a Physician Assistant in Salt Lake City, Utah. Qualified in 2008, 18 years ago. Practices with University of Utah Community Physicians Group, a 280-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
18
Licensed in
UT
In the registry since
2009
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1525 W 2100 S
Salt Lake City, UT 84119-1401
Phone: (801) 213-9700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 7270173-1206 (UT)

Record details

NPI number1205070091
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 24, 2009
Last updated in NPPESDecember 13, 2021
Certification dateDecember 13, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice University Of Utah Community Physicians Group — 280 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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