Michael Depola, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6511974-2401 Issued in UT

Practice address

1577 W 7000 S
100
West Jordan, UT 84084-7492

Phone

(801) 566-6301

Fax

(801) 566-4739

NPI assigned

May 18, 2012

Last updated

Jun 18, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Registered Physical Therapists IncGroup PAC ID 9537151733, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Registered Physical Therapists LLC

  • Physical Therapist
  • Sandy, UT
  • NPI 1477582633
  Medicare reassignment Care Compare group NPD
• Life Centre Physical Therapy

  • Preferred Provider Organization
  • Sandy, UT
  • NPI 1952468365
  NPD (past)

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1114287612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9844 S 1300 E",
            "address_2": "STE 300",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840944693",
            "telephone_number": "801-572-0690",
            "fax_number": "801-572-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1577 W 7000 S",
            "address_2": "100",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840847492",
            "telephone_number": "801-566-6301",
            "fax_number": "801-566-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPOLA",
        "first_name": "MICHAEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-18",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "6511974-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth J Delass, PT
• Tristen Delgadillo
• Florence Demeyere
• Daniel Dennison
• Madeline Denovellis
• Amber Dethlefs, PH.D.
• Jeffrey Scott Devaney
• Melannie Carina Diaz-Herrera
• Ambar Diaz
• Bradley William Digney, M.D.

• Physical Therapist in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; 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.