ANDREW WADE PHIPPEN – Physical Medicine & Rehabilitation Physician, NPI 1083069025

Physical Medicine & Rehabilitation Physician

ANDREW WADE PHIPPEN is a healthcare provider. based in American fork, Utah. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 284016-2401 (UT). The NPI Number for ANDREW WADE PHIPPEN is 1083069025

Main info

Male

28 Years Of Experience

Accepts Medicare Assignment

Name

ANDREW WADE PHIPPEN

NPI

1083069025

Phone

(801) 576-6417

Address

383 E 60 S

Enumeration Date

27 April 2016

Last Update Date

3 May 2021

Doctor Profile

Medical School Name

OTHER

Secondary Phone

8016096034

Graduation Year

1998 (28 years ago)

PAC ID

0749697076

Group Practice PAC ID

1658650361

Professional Enrollment ID

I20210607000563

Address ID

UT84043XXXXLEXXXXXXXXXX00

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience44

Completeness75

Years active:10State licenses:1Digital endpointsOther names

1,143 PHYSICAL THERAPIST IN PRIVATE PRACTICE in UT

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Provider Addresses for ANDREW WADE PHIPPEN

East 60 South, American Fork, Utah County, Utah, 84003, United States
American Fork, UT 840033835
Phone: (801) 576-6417
Fax: (801) 576-7536
Type: Location
2960 E CASTO LN
HOLLADAY, UT 841177123
Phone: (801) 556-1866
Fax: (801) 576-7536
Type: Mailing

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: 2021-06-07

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

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
I20210607000563	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.

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84003)

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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: 1658650361View full group profile