Jonathan Lavan Bundy, PT, DPT is a medicare enrolled "Physical Therapist" provider in Providence, Utah. His current practice location is
267 N Spring Creek Pkwy, Providence, Utah. You can reach out to his office (for appointments etc.) via phone at
(435) 792-9400.
Jonathan Lavan Bundy is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1255738118.
Healthcare Provider's Profile
| Full Name | Jonathan Lavan Bundy |
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| Gender | Male |
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| Speciality | Physical Therapist |
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| Location | 267 N Spring Creek Pkwy, Providence, Utah |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1255738118
- Provider Enumeration Date: 11/20/2014
- Last Update Date: 06/05/2022
Medicare PECOS Information:
- PECOS PAC ID: 5698156644
- Enrollment ID: I20220721002517
Medical Identifiers
Medical identifiers for Jonathan Lavan Bundy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1255738118 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jonathan Lavan Bundy allows following entities to bill medicare on his behalf.
| Entity Name | Springcreek Medical Center Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093075756
PECOS PAC ID: 1153587233
Enrollment ID: O20120717000459 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jonathan Lavan Bundy is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Jonathan Lavan Bundy, PT, DPT
4949 S 3535 W,
Taylorsville, UT 84129-2947
Ph: (435) 757-7546 | Jonathan Lavan Bundy, PT, DPT
267 N Spring Creek Pkwy,
Providence, UT 84332-9775
Ph: (435) 792-9400 |
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