MR. SAMUEL SMITH (OTR/L) – Occupational Therapist, NPI 1922725159

MR. SAMUEL SMITH (OTR/L) is a healthcare provider. based in Roosevelt, Utah. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OTR/L. They hold a License No. 10685382-4201 (UT). The NPI Number for MR. SAMUEL SMITH (OTR/L) is 1922725159

Main info

Male
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
MR. SAMUEL SMITH (OTR/L)
NPI
1922725159
Phone
(801) 636-7891
Address
261 E 1080 S
Enumeration Date
27 October 2022
Last Update Date
27 October 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4357096553
Graduation Year
2017 (9 years ago)
PAC ID
8022548924
Group Practice PAC ID
2365866332
Professional Enrollment ID
I20250206003555
Address ID
UT840663037RO136XX500X300

Contacts

Main Contact
ssmith901220@dcsd.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Other namesUpdated within 12 months

157 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in UT

Provider Addresses for MR. SAMUEL SMITH (OTR/L)

  • 261 E 1080 S

    ROOSEVELT, UT 840663809

    Phone: (801) 636-7891

    Type: Mailing

  • 1010 E 200 N

    ROOSEVELT, UT 840662585

    Phone: (435) 823-1769

    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: 2025-02-06

PECOS data refreshed: 2026-06-15

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
I20250206003555IOccupational 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84066)

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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: 2365866332View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeUT
Occupational Therapist In Private PracticeUT

Reviews

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Frequently asked questions

What is the 10-digit NPI for MR. SAMUEL SMITH (OTR/L)?
MR. SAMUEL SMITH (OTR/L) — NPI 1922725159 — is the standard way to identify this listing.
Can I rely on MR. SAMUEL SMITH (OTR/L) being an active provider?
As of the registry snapshot, MR. SAMUEL SMITH (OTR/L) is marked active.
What is MR. SAMUEL SMITH (OTR/L)'s primary classification?
Occupational Therapist is the headline specialty for MR. SAMUEL SMITH (OTR/L) here. Clinical services aligned with this taxonomy classification.
Where should I expect MR. SAMUEL SMITH (OTR/L) on a map?
Expect Roosevelt, Utah as a primary anchor for MR. SAMUEL SMITH (OTR/L) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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