DR. MICAH STEVEN SMITH (DPT) – Physical Therapist, NPI 1104335124

DR. MICAH STEVEN SMITH (DPT) is a healthcare provider. based in Bolingbrook, Illinois. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 13338PT (AZ). The NPI Number for DR. MICAH STEVEN SMITH (DPT) is 1104335124

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICAH STEVEN SMITH (DPT)
NPI
1104335124
Phone
Not provided
Address
790 REMINGTON BLVD
Enumeration Date
21 September 2017
Last Update Date
24 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4806295549
Graduation Year
2017 (9 years ago)
PAC ID
8527334598
Group Practice PAC ID
2466732862
Professional Enrollment ID
I20171018001535
Address ID
AZ852827289TE5110XRDXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:8State licenses:1Digital endpointsOther names

2,784 PHYSICAL THERAPIST IN PRIVATE PRACTICE in AZ

Provider Addresses for DR. MICAH STEVEN SMITH (DPT)

  • 790, Remington Boulevard, Bolingbrook, Will County, Illinois, 60440, United States

    BOLINGBROOK, IL 604404909

    Phone:

    Type: Mailing

  • 5977 E Grant Rd Ste 101

    Tucson, AZ 857122341

    Phone: (520) 777-6746

    Type: Location

  • 6261 N LA CHOLLA BLVD STE 211

    TUCSON, AZ 857413564

    Phone: (520) 822-8640

    Fax: (520) 822-8641

    Type: Location

  • East Grant Road, Catalina Foothills, Tucson, Pima County, Arizona, 85715, United States

    TUCSON, AZ 857122341

    Phone: (520) 777-6746

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-10-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20171018001535IPhysical Therapist In Private PracticeAZTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities51637$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes20033$0
97140Therapy procedure using manual technique, each 15 minutes5514$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes3513$0
View full utilization report →

Insurance plans in this area (ZIP 60440)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2466732862View full group profile
NameSpecialtyState
-IL
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeAZ
Physical Therapist In Private PracticeAZ
Physical Therapist In Private PracticeIL
-CA
-AL
-IL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeMT

Reviews

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Frequently asked questions

Can I cross-check DR. MICAH STEVEN SMITH (DPT) using NPI 1104335124?
NPI 1104335124 belongs to DR. MICAH STEVEN SMITH (DPT); compare other details if you need extra assurance.
Is there an active status for DR. MICAH STEVEN SMITH (DPT)?
For scheduling context, DR. MICAH STEVEN SMITH (DPT) is shown as active in the registry.
How would a patient describe DR. MICAH STEVEN SMITH (DPT)'s focus?
For DR. MICAH STEVEN SMITH (DPT), the primary taxonomy reads as Physical Therapist. Clinical services aligned with this taxonomy classification.
What locale is associated with DR. MICAH STEVEN SMITH (DPT)?
Directory geography for DR. MICAH STEVEN SMITH (DPT) centers on Bolingbrook, Illinois.
When was this NPI issued?
Enumeration for DR. MICAH STEVEN SMITH (DPT) is noted as September 21, 2017 where the registry provides it.

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