JARED FULLMER (DPT) – Physical Therapist, NPI 1255790176
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,143 PHYSICAL THERAPIST IN PRIVATE PRACTICE in UT
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Provider Addresses for JARED FULLMER (DPT)
1300 East, Sage Crest Subdivision Number 5, Sandy, Salt Lake County, Utah, 84094, United States
#W200
SANDY, UT 840943712
Phone:
Type: Mailing
1577, 7000 South, West Jordan, Salt Lake County, Utah, 84084, United States
#100
WEST JORDAN, UT 840847492
Phone: (801) 566-6301
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: 2016-05-10
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 |
|---|---|---|---|---|
| I20160510000786 | 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.
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 |
|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 952 | 88 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 670 | 77 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 653 | 85 | $0 |
| 97530 | Therapy procedure using functional activities | 331 | 42 | $0 |
| 97162 | Evaluation for physical therapy, typically 30 minutes | 37 | 36 | $0 |
Insurance plans in this area (ZIP 84094)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICAL THERAPY | UT | 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 54 | 22 |
| PHYSICAL THERAPY | UT | 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 37 | 20 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | UT | |
| Physical Therapist In Private Practice | UT | |
| Physical Therapist In Private Practice | UT | |
| Physical Therapist In Private Practice | UT | |
| - | UT | |
| Physical Therapist In Private Practice | UT | |
| Physical Therapist In Private Practice | UT | |
| Physical Therapist In Private Practice | AZ | |
| - | UT | |
| Physical Therapist In Private Practice | TX |
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