AVERY NICOLE ALEXANDER (DPT) – Physical Therapist, NPI 1043942097
Physical Therapist
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
1,143 PHYSICAL THERAPIST IN PRIVATE PRACTICE in UT
Provider Addresses for AVERY NICOLE ALEXANDER (DPT)
1850 Sidewinder Dr
Park City, UT 840607471
Phone: (435) 645-9095
Type: Location
1963 S 1200 E APT 310
SALT LAKE CITY, UT 841053525
Phone: (435) 659-8209
Type: Mailing
1850 SIDEWINDER DR
PARK CITY, UT 840607471
Phone: (435) 645-9095
Type: Location
PO BOX 30180
SALT LAKE CITY, UT 841300180
Phone:
Type: Mailing
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 841131103
Phone: (833) 577-3422
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: 2022-09-10
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 |
|---|---|---|---|---|
| I20220910000318 | I | Physical Therapist In Private Practice | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84060)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OR | |
| Diagnostic Radiology | UT | |
| Family Practice | UT | |
| H O S P I T A L I S T | UT | |
| O B S T E T R I C S/ G Y N E C O L O G Y | UT | |
| - | UT | |
| - | UT | |
| - | UT | |
| Family Practice | UT | |
| - | UT |
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