BOANERGES GUZMAN (DPT) – Physical Therapist, NPI 1083397475

BOANERGES GUZMAN (DPT) is a healthcare provider. based in North salt lake, Utah. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. PT61423712 (WA). The NPI Number for BOANERGES GUZMAN (DPT) is 1083397475

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
BOANERGES GUZMAN (DPT)
NPI
1083397475
Phone
(801) 987-8600
Address
PO BOX 540640
Enumeration Date
10 August 2023
Last Update Date
11 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5098295230
Graduation Year
2023 (3 years ago)
PAC ID
7416301205
Group Practice PAC ID
7012141781
Professional Enrollment ID
I20230927003589
Address ID
WA989539432ZI513XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

3,527 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WA

Provider Addresses for BOANERGES GUZMAN (DPT)

  • PO BOX 540640

    NORTH SALT LAKE, UT 840540640

    Phone: (801) 987-8600

    Type: Mailing

  • 513 1ST AVE

    ZILLAH, WA 989539432

    Phone: (509) 829-5230

    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: 2023-09-27

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
I20230927003589IPhysical Therapist In Private PracticeWATBD

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 84054)

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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: 7012141781View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeUT
Physical Therapist In Private PracticeUT
-NH

Reviews

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Frequently asked questions

What unique ID ties claims to BOANERGES GUZMAN (DPT)?
NPI 1083397475 is assigned to BOANERGES GUZMAN (DPT) under the national enumeration system.
Is BOANERGES GUZMAN (DPT)'s NPI currently valid?
The extract we use shows BOANERGES GUZMAN (DPT) as active.
What kind of provider is BOANERGES GUZMAN (DPT)?
The page reflects Physical Therapist for BOANERGES GUZMAN (DPT). Clinical services aligned with this taxonomy classification.
Where does public data place BOANERGES GUZMAN (DPT)?
The snapshot lists North Salt Lake, Utah for BOANERGES GUZMAN (DPT); download NPPES for the complete set.
How can I contact BOANERGES GUZMAN (DPT)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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