Individual provider Active NPI

Madeline Kate Ekins, PT, DPT, CSCS

  • Physical Therapist
  • Park City, UT
National Provider Identifier
1568210482
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
139679782401 Issued in UT
Practice address
4554 Forestdale Dr Unit C16
Park City, UT 84098-1392
Phone
(435) 494-1336
NPI assigned
May 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 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 139679782401 UT Primary

Addresses

Primary practice location

4554 Forestdale Dr Unit C16
Park City, UT 84098-1392

Mailing address

1156 E 3300 S Apt 211
Millcreek, UT 84106-4357
Phone (801) 884-9966

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240529001793 UT Practitioner - Physical Therapist in Private Practice 5698117125 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
Motion Ut, LLCGroup PAC ID 0143630285, 6 clinicians

Practice addresses (Care Compare)

4554 Forestdale Dr
Unit C16
Park City, UT 84098-1392
Phone (603) 568-9461

4554 Forestdale Dr Unit
C16
Park City, UT 84098-1392

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
139679782401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Motion Ut, LLC CurrentSince Jun 15, 2024 Accepting new patients

Locations

1716 N Highway 40
Ste 101
Heber City, UT 84032
Phone (435) 294-2664

4554 Forestdale Dr
Unit C16
Park City, UT 84098
Phone (435) 494-1336

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": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1568210482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 E 3300 S APT 211",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841064357",
            "telephone_number": "801-884-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4554 FORESTDALE DR UNIT C16",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840981392",
            "telephone_number": "435-494-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKINS",
        "first_name": "MADELINE",
        "middle_name": "KATE",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "139679782401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.