STEPHANIE ANN OBRADOVICH (P.T.) – Neurology Physical Therapist, NPI 1255452306

Neurology Physical Therapist

STEPHANIE ANN OBRADOVICH (P.T.) is a healthcare provider. based in Salt lake city, Utah. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials P.T.. They hold a License No. 107349-2401 (UT). The NPI Number for STEPHANIE ANN OBRADOVICH (P.T.) is 1255452306

Main info

Female

Sole Proprietor

30 Years Of Experience

Accepts Medicare Assignment

Name

STEPHANIE ANN OBRADOVICH (P.T.)

NPI

1255452306

Phone

(801) 314-2097

Address

5770 S 250 E

Enumeration Date

3 April 2007

Last Update Date

17 October 2023

Doctor Profile

Medical School Name

OTHER

Secondary Phone

4356587377

Graduation Year

1996 (30 years ago)

PAC ID

9739528191

Group Practice PAC ID

1850209420

Professional Enrollment ID

I20240417003439

Address ID

UT840607552PA900XXDRXX400

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience62

Completeness75

Years active:19State licenses:1Digital endpointsOther names

1,143 PHYSICAL THERAPIST IN PRIVATE PRACTICE in UT

Provider Addresses for STEPHANIE ANN OBRADOVICH (P.T.)

5770 S 250 E
SUITE G
SALT LAKE CITY, UT 841078100
Phone: (801) 314-2097
Mailing address matches the actual address.

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: 2024-04-17

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

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
I20240417003439	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 84107)

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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

Name	Specialty	State
MR. SARUNAS SLIESORAITIS (DO, PHARM D)	-	OR
BRETT A CHRISTIAN (M.D.)	Diagnostic Radiology	UT
STEPHEN CRAIG MERRELL (M.D., M.P.H.)	Family Practice	UT
MIKHAIL SHIPOTKO (MD)	H O S P I T A L I S T	UT
RICHARD OTT (M.D.)	O B S T E T R I C S/ G Y N E C O L O G Y	UT
MS. SHARON A KORHEL (APRN)	-	UT
DR. TIMOTHY TRASK (M.D.)	-	UT
JAMES F ORME (MD)	-	UT
JUNE C. STEINVORTH (MD)	Family Practice	UT
RYAN NELSON JONES (M.D.)	-	UT

Reviews

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Frequently asked questions

Is STEPHANIE ANN OBRADOVICH (P.T.) listed with a National Provider Identifier?

Yes — STEPHANIE ANN OBRADOVICH (P.T.) has NPI 1255452306 on file in the registry.

Is there an active status for STEPHANIE ANN OBRADOVICH (P.T.)?

For scheduling context, STEPHANIE ANN OBRADOVICH (P.T.) is shown as active in the registry.

How would a patient describe STEPHANIE ANN OBRADOVICH (P.T.)'s focus?

For STEPHANIE ANN OBRADOVICH (P.T.), the primary taxonomy reads as Neurology Physical Therapist. Clinical services aligned with this taxonomy classification.

Is STEPHANIE ANN OBRADOVICH (P.T.) associated with Salt Lake City?

Public fields place STEPHANIE ANN OBRADOVICH (P.T.) around Salt Lake City, Utah. Always confirm the exact site before visiting.

What does 2 location(s) imply?

2 practice locations appear in the available data.