Nicole Carli Gray, DPT in Farr West, UT - Medicare Physical Therapist Provider

Nicole Carli Gray, DPT is a medicare enrolled "Physical Therapist" provider in Farr West, Utah. Her current practice location is 2850 N 2000 W Ste 204, Farr West, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 731-5421.

Nicole Carli Gray is licensed to practice in Utah (license number 11805453-8016) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1750998316.

Contact Information

	Nicole Carli Gray, DPT
	2850 N 2000 W Ste 204, Farr West, UT 84404-9230
	(801) 731-5421
	(801) 732-0303

Map and Direction

Healthcare Provider's Profile

Full Name	Nicole Carli Gray
Gender	Female
Speciality	Physical Therapist
Location	2850 N 2000 W Ste 204, Farr West, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1750998316
Provider Enumeration Date: 09/28/2020
Last Update Date: 10/28/2022

Medicare PECOS Information:

PECOS PAC ID: 9638548779
Enrollment ID: I20221212001277

Medical Identifiers

Medical identifiers for Nicole Carli Gray such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750998316	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	11805453-8016 (Utah)	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. Nicole Carli Gray allows following entities to bill medicare on her behalf.

Provider Name	Sundance Physical Therapy Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1932265758 PECOS PAC ID: 8729067236 Enrollment ID: O20040719000256

Provider Name	Sundance Physical Therapy Farr West
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1093966509 PECOS PAC ID: 4183788813 Enrollment ID: O20090126000199

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. Nicole Carli Gray 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
Nicole Carli Gray, DPT 5375 S 300 E, Washington Terrace, UT 84405-6941 Ph: (801) 726-9126	Nicole Carli Gray, DPT 2850 N 2000 W Ste 204, Farr West, UT 84404-9230 Ph: (801) 731-5421

Reviews and Comments

Physical Therapist in Farr West, UT

Dr. Ryan Maxfield, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2850 N 2000 W Ste 204, Farr West, UT 84404 Phone: 801-731-5421 Fax: 801-732-0303
Sundance Physical Therapy Farr West Physical Therapist Medicare: Medicare Enrolled Practice Location: 2850 N 2000 W Ste 204, Farr West, UT 84404 Phone: 801-731-5421 Fax: 801-732-0303
Crystal D Danley, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2850 N 2000 W Ste 204, Farr West, UT 84404 Phone: 801-731-5421
Dr. Camille Royer Fritzler, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2850 N 2000 W Ste 204, Farr West, UT 84404 Phone: 801-731-5421
Bryce Parker, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1741 N 2000 W, Farr West, UT 84404 Phone: 801-827-0203 Fax: 801-407-9784
Jacob Robert Peel, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1741 N 2000 W Ste 6, Farr West, UT 84404 Phone: 801-827-0203 Fax: 801-407-9784

Nicole Carli Gray, DPT - Medicare Physical Therapist in Farr West, UT