MARK SEDERBERG (D.O.) – Sports Medicine (Physical Medicine & Rehabilitation) Physician, NPI 1255793576
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
863 PHYSICAL MEDICINE AND REHABILITATION in TX
Provider Addresses for MARK SEDERBERG (D.O.)
1500 S Main St
Fort Worth, TX 761044917
Phone: (817) 702-3431
Type: Location
590, Wakara Way, Research Park, Salt Lake City, Salt Lake County, Utah, 84108, United States
SALT LAKE CITY, UT 841081200
Phone: (801) 587-5400
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $79.
Total Amount is formed as General ($79) + Research ($0) + Ownership ($0) = $79.
Last reported payment date: 2024-11-18 • Largest payer in this snapshot: Orthofix Medical, Inc. ($25).
Total Amount
$79
General + Research + Ownership
Payments
4
Total payment records
General Amount
$79
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Orthofix Medical, Inc. | $25 |
| Merz Pharmaceuticals, LLC | $20 |
| Bioventus LLC | $18 |
| Ferring Pharmaceuticals Inc. | $16 |
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: 2020-06-12
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200612000595 | I | Physical Medicine And Rehabilitation | UT | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 160 | 28 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 89 | 46 | $0 |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 21 | 15 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 20 | 20 | $0 |
Insurance plans in this area (ZIP 76104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Sports Medicine | UT | |
| Sports Medicine | UT | |
| Orthopedic Surgery, Sports Medicine | MS | |
| Family Practice | IN | |
| Sports Medicine, Family Practice | UT | |
| Family Practice, Sports Medicine | WY |
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