Foot & Ankle Specialists of Utah – Foot & Ankle Surgery Podiatrist, NPI 1639200215
Foot & Ankle Surgery Podiatrist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Foot & Ankle Specialists of Utah
PO BOX 1249
BOUNTIFUL, UT 840111249
Phone: (801) 296-2113
Fax: (801) 296-1715
Type: Mailing
596 W 750 S
SUITE 200
BOUNTIFUL, UT 840107268
Phone: (801) 635-8825
Fax: (801) 397-1938
Type: Location
3777 PECOS MCLEOD STE 103
Las Vegas, NV 891214265
Phone: (206) 703-2204
Fax: (702) 434-1976
Type: Location
8008 Menaul Blvd NE
Albuquerque, NM 871104608
Phone: (206) 703-2204
Fax: (505) 296-1392
Type: Location
1618 N Lee Trevino Dr Ste D
El Paso, TX 799365104
Phone: (206) 703-2204
Type: Location
1060 Chambers St
Eugene, OR 974023745
Phone: (206) 703-2204
Type: Location
434 W ASCENSION WAY STE 425
MURRAY, UT 841233102
Phone: (206) 703-2204
Type: Mailing
596 W 750 S STE 200
BOUNTIFUL, UT 840107281
Phone: (206) 703-2204
Fax: (801) 397-1938
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: 2024-07-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-12-31 (891 days ago).
Enrollment records
6
Earliest due date
2023-12-31
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 |
|---|---|---|---|---|
| O20050903000007 | O | Clinic/Group Practice | UT | TBD |
| O20100930048796 | O | Physician - Podiatry | UT | 2023-12-31 |
| O20160629000276 | O | Clinic/Group Practice | NM | 2024-02-29 |
| O20230605001910 | O | Clinic/Group Practice | OR | TBD |
| O20240328000987 | O | Clinic/Group Practice | NV | TBD |
| O20240724000926 | O | Clinic/Group Practice | TX | TBD |
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.
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 84011)
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