WASATCH PODIATRY PLLC – Podiatrist, NPI 1114224805

WASATCH PODIATRY PLLC is a healthcare provider. based in Ogden, Utah. specializing in Podiatrist. The organization holds a License No. 7259622-0501 (UT). The NPI Number for WASATCH PODIATRY PLLC is 1114224805

Main info

Organization
Name
WASATCH PODIATRY PLLC
NPI
1114224805
Phone
(801) 430-8406
Address
PO BOX 150383
Authorized Official
SUSAN AGRES OWNER DPM
Enumeration Date
16 February 2011
Last Update Date
10 March 2026
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness85
Years active:15State licenses:1Digital endpointsOther names

Provider Addresses for WASATCH PODIATRY PLLC

  • PO BOX 150383

    OGDEN, UT 844150383

    Phone: (801) 430-8406

    Type: Mailing

  • 1322 32ND ST

    OGDEN, UT 844030902

    Phone: (801) 430-8406

    Type: Mailing

  • 5275 ADAMS AVE PKWY

    SUITE A

    OGDEN, UT 844056748

    Phone: (801) 430-8406

    Type: Location

  • 5275 Adams Ave Pkwy

    Suite A

    Ogden, UT 844056748

    Phone: (801) 430-8406

    Type: Location

  • 5275 Adams Ave Pkwy Ste A

    Ogden, UT 844057238

    Phone: (801) 430-8406

    Fax: (801) 393-6092

    Type: Location

  • 81 E Center St

    Kaysville, UT 840371920

    Phone: (801) 430-8406

    Type: Location

  • 1679 SHADOW VALLEY DR

    OGDEN, UT 844034626

    Phone: (801) 430-8406

    Fax: (801) 393-6092

    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: 2011-04-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-09-30 (251 days ago).

Enrollment records

1

Earliest due date

2025-09-30

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
O20110425000795OClinic/Group PracticeUT2025-09-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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 84415)

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Reviews

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Frequently asked questions

Can I cross-check WASATCH PODIATRY PLLC using NPI 1114224805?
NPI 1114224805 belongs to WASATCH PODIATRY PLLC; compare other details if you need extra assurance.
Is there an active status for WASATCH PODIATRY PLLC?
For scheduling context, WASATCH PODIATRY PLLC is shown as active in the registry.
What area of care is associated with WASATCH PODIATRY PLLC?
WASATCH PODIATRY PLLC's record emphasizes Podiatrist. Clinical services aligned with this taxonomy classification.
Is WASATCH PODIATRY PLLC associated with Ogden?
Public fields place WASATCH PODIATRY PLLC around Ogden, Utah. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for WASATCH PODIATRY PLLC is noted as February 16, 2011 where the registry provides it.

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