KATIE NICOLE SAMUELS (PT) – Physical Therapist, NPI 1205300308

KATIE NICOLE SAMUELS (PT) is a healthcare provider. based in Salt lake city, Utah. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. LPT-30440 (AZ). The NPI Number for KATIE NICOLE SAMUELS (PT) is 1205300308

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
KATIE NICOLE SAMUELS (PT)
NPI
1205300308
Phone
(801) 478-7780
Address
1685 W 2200 S
Enumeration Date
11 January 2019
Last Update Date
11 January 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8012853400
Graduation Year
2018 (8 years ago)
PAC ID
7113389453
Group Practice PAC ID
1850209420
Professional Enrollment ID
I20230817002619
Address ID
UT840657215RI3741X1260308
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

1,143 PHYSICAL THERAPIST IN PRIVATE PRACTICE in UT

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Provider Addresses for KATIE NICOLE SAMUELS (PT)

  • 1685, 2200 South, West Valley City, Salt Lake County, Utah, 84119, United States

    SALT LAKE CITY, UT 841191456

    Phone: (801) 478-7780

    Type: Location

  • 4725 S 1300 E APT 21

    MILLCREEK, UT 841175099

    Phone: (801) 413-8868

    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: 2023-08-17

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
I20230817002619IPhysical 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes39736$0
97161Evaluation for physical therapy, typically 20 minutes2524$0
View full utilization report →

Insurance plans in this area (ZIP 84119)

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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

What is the registry number for KATIE NICOLE SAMUELS (PT)?
The registry entry for KATIE NICOLE SAMUELS (PT) shows NPI 1205300308.
Is KATIE NICOLE SAMUELS (PT)'s NPI status active today?
Active status means KATIE NICOLE SAMUELS (PT)'s NPI record is not deactivated in the public file.
Which specialty label fits KATIE NICOLE SAMUELS (PT)?
NPPES ties KATIE NICOLE SAMUELS (PT) to Physical Therapist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to KATIE NICOLE SAMUELS (PT)?
KATIE NICOLE SAMUELS (PT) is associated with Salt Lake City, Utah in the same public data insurers reference.
Why is information missing for KATIE NICOLE SAMUELS (PT)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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