Individual provider Active NPI

Bryan A Gallaer, PT, DPT, ATC

  • Physical Therapist
  • Cottonwood Heights, UT
National Provider Identifier
1316766405
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27813 Issued in MA
Practice address
1950 E Fort Union Blvd # 2
Cottonwood Heights, UT 84121-6894
Phone
(801) 943-1041
NPI assigned
Oct 7, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 27813 MA Primary

Addresses

Primary practice location

1950 E Fort Union Blvd # 2
Cottonwood Heights, UT 84121-6894

Mailing address

41 Summerfield GDNS
Shelton, CT 06484-6300
Phone (203) 727-4821

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241101002135 UT Practitioner - Physical Therapist in Private Practice 3971036617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foundation Physical TherapyGroup PAC ID 6204230394, 12 clinicians

Practice addresses (Care Compare)

11962 S Anthem Park Blvd
Suite 250
Herriman, UT 84096-5732
Phone (801) 981-5171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27813MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation Physical Therapy Physical Therapist CurrentSince Nov 8, 2024 Accepting new patients

Locations

1225 E Fort Union Blvd
Ste 100
Cottonwood Heights, UT 84047
Phone (385) 213-2518

11962 S Anthem Park Blvd
Ste 250
Herriman, UT 84096
Phone (385) 473-6438

1628 W 11010 S
Ste 101
South Jordan, UT 84095
Phone (801) 419-1196

Organizations & group practices 1

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": "1728259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1316766405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 SUMMERFIELD GDNS",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846300",
            "telephone_number": "203-727-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 E FORT UNION BLVD # 2",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841216894",
            "telephone_number": "801-943-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAER",
        "first_name": "BRYAN",
        "middle_name": "A",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "27813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood Heights, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.