Thomas Bezemer, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

49452432401 Issued in UT

Practice address

7600 Glenwild Dr
Park City, UT 84098-5587

Phone

(435) 901-1139

Fax

(435) 940-9127

NPI assigned

Jan 24, 2007

Last updated

Nov 30, 2017By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Proform Athletics, LLC

  • Orthopedic Physical Therapist
  • Park City, UT
  • NPI 1689909772
  Medicare reassignment NPD Authorized official
• Alpine Sports Medicine LLC

  • Physical Therapist
  • Park City, UT
  • NPI 1982776530
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512000000000",
    "number": "1679628002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7461 BROOK HOLLOW LOOP RD",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840988262",
            "telephone_number": "435-901-1139",
            "fax_number": "435-940-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 GLENWILD DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985587",
            "telephone_number": "435-901-1139",
            "fax_number": "435-940-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEZEMER",
        "first_name": "THOMAS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2017-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "49452432401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280669988016",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph H Berman, MD
• Nichole Bernhard, O.T.R.
• Cynthia C Berwald, PA
• Kirstyn Besch, MA, LCMHC
• Jennifer Bevilacqua
• Poushali Bhattacharjee, M.D.
• Todd Andrew Bigatel, M.D.
• Amy Adair Bingham
• Rachel Bittenson, OTR/L
• BK Roots, LLC

• Physical Therapist in Park City, UT
• Providers in Park City, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; 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.