Paul D. Anderson, MPT
Individual provider Active NPI Orthopedic Physical Therapist · Alpine, UT
NPI 1063663540 · NPPES record last updated Oct 2, 2008
Key facts
- NPI
- 1063663540
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopedic Physical Therapist 2251X0800X
- License
- 4777580-2401 (UT)
- Practice address
- 75 W Main Street CT Ste 100
Alpine, UT 84004-5602 - Phone
- (801) 216-4298
- Fax
- (801) 216-4298
- NPI assigned
- Oct 2, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
235 S Main St
Alpine, UT 84004-1682
Phone (801) 216-4298
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090504000121 | UT | Practitioner - Physical Therapist in Private Practice | 0648328534 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4777580-2401 | UT | MD | Orthopedic Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 4777580-2401 | UT | Yes |
Addresses
Primary practice location
75 W Main Street CT Ste 100
Alpine, UT 84004-5602
Mailing address
75 W Main Street CT Ste 100
Alpine, UT 84004-5602
Phone (801) 216-4298
Other providers in Alpine, UT
- Alpine Family Medicine LLC
- Alpine Physical Therapy LLC
- Alpine Recovery Lodge LLC
- Alpine Recovery Lodge LLC
- Chris Donald Anderson
- Douglas Whitney Ashton
- Amber Astle
- Azova Care Group (FL), PLLC
- Beehive Home Care
- Brennan Bellon
All providers in Alpine, UT · Orthopedic Physical Therapist in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.