TRACY R SYDDALL (PA-C) – Medical Physician Assistant, NPI 1205070091
Medical Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
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Provider Addresses for TRACY R SYDDALL (PA-C)
Sage Vista Way, Oquirrh Park, Daybreak, South Jordan, Salt Lake County, Utah, 84009, United States
SOUTH JORDAN, UT 840953955
Phone: (801) 243-6178
Type: Mailing
1525, 2100 South, Salt Lake City, Salt Lake County, Utah, 84119, United States
SALT LAKE CITY, UT 841191401
Phone: (801) 213-9700
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: 2009-06-16
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 |
|---|---|---|---|---|
| I20090616000425 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 90 | 88 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 49 | 48 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 19 | 19 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 14 | 14 | $0 |
Insurance plans in this area (ZIP 84095)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | UT | |
| Internal Medicine | UT | |
| P O D I A T R Y | UT | |
| Physician Assistant | UT | |
| Family Practice | UT | |
| Family Practice | MT | |
| Family Practice | UT | |
| Family Practice | UT | |
| Physician Assistant | UT | |
| Physician Assistant | UT |
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