Organization Active NPI

Utah Podiatry Group LLC

  • Foot & Ankle Surgery Podiatrist
  • Eagle Mountain, UT
National Provider Identifier
1962331520
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
UTAH PODIATRY GROUP LLC
Practice address
3435 E Pony Express Pkwy Ste 140
Eagle Mountain, UT 84005-5548
Phone
(801) 789-2444
NPI assigned
May 18, 2026
Organization subpart
Yes
Parent organization
UTAH PODIATRY GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Authorized official

Name
Alexander Reyzelman, DPM
Title
Cmo
Phone
(415) 292-0638

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

3435 E Pony Express Pkwy Ste 140
Eagle Mountain, UT 84005-5548

Mailing address

3435 E Pony Express Pkwy Ste 140
Eagle Mountain, UT 84005-5548
Phone (801) 789-2444

National Provider Directory

National Provider Directory
Tax ID family
Utah Podiary Group PC13 organizations share this tax ID, including this one
Part of
Utah Podiary Group PC

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1779062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779062400000",
    "number": "1962331520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 E PONY EXPRESS PKWY STE 140",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840055548",
            "telephone_number": "801-789-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 E PONY EXPRESS PKWY STE 140",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840055548",
            "telephone_number": "801-789-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH PODIATRY GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UTAH PODIATRY GROUP LLC",
        "enumeration_date": "2026-05-18",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A",
        "authorized_official_last_name": "REYZELMAN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "415-292-0638",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Mountain, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.