TRACY R SYDDALL PA-C
NPI 1205070091
Physician Assistant - Medical in Salt Lake City, UT

Q: What is Tracy Syddall's NPI number?

The NPI number for Tracy Syddall is 1205070091. It was assigned to this individual provider in the NPPES registry on April 24, 2009.

Q: What is Tracy Syddall's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Tracy Syddall was last updated on December 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 24, 2009PECOS EnrolledAccepts Medicare Assignment

1525 W 2100 S, SALT LAKE CITY, UT 84119(801) 213-9700 Get Directions Write a Review

NPPES record last updated: December 13, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Tracy R Syddall Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRACY R SYDDALL PA-C (NPI 1205070091) is an individual medical provider in Salt Lake City, Utah, licensed in Utah (7270173-1206) and active in the NPI registry since April 2009. He is enrolled in Medicare PECOS, is affiliated with University Of Utah Hospitals And Clinics, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1205070091

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameTRACY R SYDDALLCredential: PA-C

Location Address1525 W 2100 SSalt Lake City, UT 84119-1401

Mailing Address10479 S Sage Vista WaySouth Jordan, UT 84095-3955 · (801) 243-6178

Phone(801) 213-9700

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateApril 24, 2009

Last NPPES UpdateDecember 13, 2021

NPPES CertifiedDecember 13, 2021

✔ NPI 1205070091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in UT · 7270173-1206

1525 W 2100 S, Salt Lake City, UT 84119

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tracy R Syddall Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1557396256

PECOS Enrollment IDI20090616000425

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

127 services108 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

27 services27 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

16 services16 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

15 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Utah Hospitals And Clinics

Acute Care Hospitals · Salt Lake City, UT

5/5 CMS rating

OwnershipGovernment - State

CMS Certification Number460009

Location50 North Medical DriveSalt Lake City, UT 84132 · Salt Lake County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CYNTHIA M MATHEWSON MD

Family Medicine