Individual provider Active NPI

Andrew Fast

  • Physical Therapist
  • Park City, UT
National Provider Identifier
1629512264
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10156968-2401 Issued in UT
Practice address
900 Round Valley Dr
Park City, UT 84060-7552
Phone
(435) 658-7350
NPI assigned
Dec 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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 10156968-2401 UT Primary

Addresses

Primary practice location

900 Round Valley Dr
Park City, UT 84060-7552

Mailing address

PO Box 25537
Salt Lake City, UT 84125-0537

Other practice location 1

5245 S College Dr
Murray, UT 84123-2722
Phone (206) 799-5374

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231018003204 UT Practitioner - Physical Therapist in Private Practice 2961857420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
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)

900 Round Valley Dr
Park City, UT 84060-7552
Phone (435) 658-7377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Sep 11, 2023 Accepting new patients
Ihc Health Services Inc Physical Therapist CurrentSince Sep 11, 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

900 Round Valley Dr
Ste 200
Park City, UT 84060
Phone (435) 658-7246

900 Round Valley Dr
Park City, UT 84060
Phone (435) 658-7000

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": "1481846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1629512264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25537",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 ROUND VALLEY DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607552",
            "telephone_number": "435-658-7350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5245 S College Dr",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841232722",
            "country_code": "US",
            "telephone_number": "206-799-5374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAST",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-16",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "10156968-2401",
            "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 Jun 8, 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.