Individual provider Active NPI

Zebadia Pessetto

  • Physical Therapist
  • North Ogden, UT
National Provider Identifier
1003218512
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9492271-2401 Issued in UT
Practice address
2400 N Washington Blvd
North Ogden, UT 84414-7233
Phone
(801) 786-7700
Fax
(801) 786-7705
NPI assigned
Sep 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Physical Therapist 225100000X 9492271-2401 UT Primary

Addresses

Primary practice location

2400 N Washington Blvd
North Ogden, UT 84414-7233

Mailing address

PO Box 30180
Salt Lake City, UT 84130-0180

Other practice location 1

3895 Harrison Blvd
Ogden, UT 84403-2312
Phone (801) 387-7678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231023000290 UT Practitioner - Physical Therapist in Private Practice 4789948167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

2400 N Washington Blvd
Ogden, UT 84414-7233
Phone (801) 786-7700

7302 S Bingham Junction Blvd
Midvale, UT 84047-4804
Phone (801) 442-5502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9492271-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Sep 10, 2023 Accepting new patients
Ihc Health Services Inc Physical Therapist CurrentSince Sep 10, 2023 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

380 E 1500 S
Ste 102
Heber City, UT 84032
Phone (435) 657-4690

7302 S Bingham Junction Blvd
Midvale, UT 84047
Phone (801) 442-3300

2400 N Washington Blvd
Ogden, UT 84414
Phone (801) 387-8300

5171 S Cottonwood St
Ste 900
Salt Lake City, UT 84107
Phone (801) 507-2050

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1003218512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30180",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N WASHINGTON BLVD",
            "city": "NORTH OGDEN",
            "state": "UT",
            "postal_code": "844147233",
            "telephone_number": "801-786-7700",
            "fax_number": "801-786-7705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3895 Harrison Blvd",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "844032312",
            "country_code": "US",
            "telephone_number": "801-387-7678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PESSETTO",
        "first_name": "ZEBADIA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-16",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "9492271-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.