MEDICARE: JEFFREY J ROCCO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	60233511205	UT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	005587209	OTHER		MEDICARE PART B
9	000055872	OTHER		MEDICARE PART B

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	H65675	OTHER	PUBLIC EMPLOYEES
4	60233511200001	OTHER	HEALTHWISE
5	60233511200001	OTHER	BC OF WYO
6	60233511200001	OTHER	VALUECARE
7	60233511200001	OTHER	BCBS OF OTHER STATE
8	60233511200001	OTHER	FED BCBS
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	60233511200001	OTHER	BCBS
12	60233511200001	OTHER	BCBS MEDADVANTAGE
13	86192	OTHER	PUBLIC EMPLOYEES

General Provider Information

NPI Number	:	1306818190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY J ROCCO MD

Provider Business Mailing Address
First Line	:	5782 ADAMS AVE PKWY
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84405-6947
Country	:	US
Telephone Number	:	801-917-8020
Fax Number	:	801-917-8001

Provider Business Practice Location Address
First Line	:	5782 ADAMS AVENUE PARKWAY
Second Line	:
City	:	WASHINGTON TERRACE
State	:	UT
Zip	:	84405
Country	:	US
Telephone Number	:	801-917-8000
Fax Number	:	801-917-8001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	09/12/2022

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