UTAH PODIATRY GROUP LLC – Foot & Ankle Surgery Podiatrist, NPI 1659540359
Foot & Ankle Surgery Podiatrist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for UTAH PODIATRY GROUP LLC
Salt Lake Regional Medical Center, 82, 1100 East, East Central, Salt Lake City, Salt Lake County, Utah, 84102, United States
STE 301
SALT LAKE CITY, UT 84102
Phone: (801) 505-5277
Fax: (801) 505-5280
Type: Location
8822 S Redwood Rd Ste E121
West Jordan, UT 840885763
Phone: (801) 285-7060
Fax: (801) 285-7061
Type: Location
520 Medical Dr Ste 230
Bountiful, UT 840108932
Phone: (801) 292-5070
Fax: (801) 505-5277
Type: Location
PO BOX 30015
SALT LAKE CITY, UT 841300015
Phone: (801) 451-6060
Fax: (801) 797-9154
Type: Mailing
PO BOX 849795
LOS ANGELES, CA 900849795
Phone: (801) 505-5277
Fax: (801) 797-9154
Type: Mailing
24 S 1100 E STE 210
SALT LAKE CITY, UT 841021580
Phone: (801) 505-5277
Fax: (801) 505-5280
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: 2025-12-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| O20220615000423 | O | Clinic/Group Practice | NV | TBD |
| O20251203003494 | O | Clinic/Group Practice | CA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84102)
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