DR. STUART ELIOT WILLICK (MD) – Physical Medicine & Rehabilitation Physician, NPI 1720169915
Physical Medicine & Rehabilitation Physician
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Profile Insights
NPPES metrics only — not quality of care.
105 SPORTS MEDICINE in UT
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Provider Addresses for DR. STUART ELIOT WILLICK (MD)
1493, Lowell Avenue, Park City, Summit County, Utah, 84060, United States
PARK CITY, UT 84060
Phone: (435) 655-7970
Type: Location
PO BOX 58108
SALT LAKE CITY, UT 841580108
Phone: (801) 581-3998
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: 2004-09-03
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 |
|---|---|---|---|---|
| I20040903000475 | I | Sports Medicine | 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 | 89 | 63 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 57 | 57 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 34 | 32 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 19 | 19 | $0 |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 12 | 12 | $0 |
Insurance plans in this area (ZIP 84060)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| SPORTS MEDICINE | UT | 20610 | Aspiration and/or injection of large joint or joint capsule | 38 | 29 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Medicine And Rehabilitation | UT | |
| O B S T E T R I C S/ G Y N E C O L O G Y | UT | |
| Nurse Practitioner | UT | |
| Physical Medicine And Rehabilitation | IL | |
| Physician Assistant | NC | |
| - | UT | |
| - | UT | |
| Physical Medicine And Rehabilitation | UT | |
| Physical Medicine And Rehabilitation | UT | |
| Physical Medicine And Rehabilitation | IL |
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