MR. S. BRIAN BENNETT (OT) – Occupational Therapist, NPI 1164439691

MR. S. BRIAN BENNETT (OT) is a healthcare provider. based in Provo, Utah. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OT. They hold a License No. 5110123-4201 (UT). The NPI Number for MR. S. BRIAN BENNETT (OT) is 1164439691

Main info

Male
27 Years Of Experience
Accepts Medicare Assignment
Name
MR. S. BRIAN BENNETT (OT)
NPI
1164439691
Phone
(801) 357-1250
Address
1157 N 300 W Ste 211
Enumeration Date
1 August 2006
Last Update Date
30 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8013571250
Graduation Year
1999 (27 years ago)
PAC ID
4880047596
Group Practice PAC ID
1850209420
Professional Enrollment ID
I20240130001240
Address ID
UT846046124PR1157X300X302

Contacts

Main Contact
https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguest_Service
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness95
Years active:19State licenses:1Other names

156 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in UT

Provider Addresses for MR. S. BRIAN BENNETT (OT)

  • 1157 N 300 W Ste 211

    Provo, UT 846046124

    Phone: (801) 357-1250

    Type: Location

  • Utah Valley Hospital, 1034, North 500 West, North Park, Provo, Utah County, Utah, 84604, United States

    PROVO, UT 846043380

    Phone: (801) 357-7475

    Fax: (801) 357-7997

    Type: Location

  • PO BOX 25537

    SALT LAKE CITY, UT 841250537

    Phone: (801) 357-1250

    Type: Mailing

  • PO BOX 30180

    SALT LAKE CITY, UT 841300180

    Phone: (801) 357-7475

    Fax: (801) 357-7997

    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: 2024-01-30

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
I20240130001240IOccupational Therapist In Private PracticeUTTBD

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 84604)

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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: 1850209420View full group profile

Reviews

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Frequently asked questions

Does MR. S. BRIAN BENNETT (OT) have a public NPI I can cite?
Public records show MR. S. BRIAN BENNETT (OT) under NPI 1164439691.
Should I treat MR. S. BRIAN BENNETT (OT) as an active provider?
Patients and plans typically see MR. S. BRIAN BENNETT (OT) as active in the national extract.
What type of care does MR. S. BRIAN BENNETT (OT) provide?
MR. S. BRIAN BENNETT (OT)'s profile centers on Occupational Therapist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to MR. S. BRIAN BENNETT (OT)?
MR. S. BRIAN BENNETT (OT) is associated with Provo, Utah in the same public data insurers reference.
Why is information missing for MR. S. BRIAN BENNETT (OT)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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