Derek Rodeback, D.O.
NPI 1053751032 · Sports Medicine (Physical Medicine & Rehabilitation) Physician · Bountiful, UT
Enrolled with Medicare as Practitioner - Physical Medicine and Rehabilitation · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Derek Rodeback, D.O. is a Sports Medicine (Physical Medicine & Rehabilitation) Physician provider in Bountiful, UT (NPI 1053751032).
Provider details
- NPI number
- 1053751032
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- License
- DR.0061855 (CO)
Specialties & taxonomies
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianPrimary2081S0010XLicense 12005709-1204 (UT)
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2013-07-05
- Last updated
- 2025-05-22
- Certified
- 2025-05-22
Frequently asked questions
- What is Derek Rodeback's NPI number?
- Derek Rodeback's National Provider Identifier (NPI) is 1053751032, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Derek Rodeback's specialty?
- Derek Rodeback is listed in the NPPES registry with a primary specialty of Sports Medicine (Physical Medicine & Rehabilitation) Physician (Allopathic & Osteopathic Physicians).
- Where is Derek Rodeback located?
- Derek Rodeback's practice location on file with NPPES is 1818 Mueller Park Rd, Bountiful, UT 84010-1105.
- What is Derek Rodeback's phone number?
- The practice phone number listed in the NPPES registry for Derek Rodeback is (453) 414-9858.
- Does Derek Rodeback accept Medicare?
- Derek Rodeback is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Derek Rodeback's NPI active?
- Yes — Derek Rodeback's NPI (1053751032) is active in the NPPES registry as of the last update on 2025-05-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.