Performance West Physical Therapy - Medicare Physical Therapist in Bountiful, UT

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Performance West Physical Therapy is a medicare enrolled "Physical Therapist" provider in Bountiful, Utah. Their current practice location is 1551 Renaissance Towne Dr, Ste 350, Bountiful, Utah. You can reach out to their office (for appointments etc.) via phone at (801) 295-3553.

Performance West Physical Therapy is licensed to practice in Utah (license number 200631198) and it also participates in the medicare program. Performance West Physical Therapy is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1720148240.

Contact Information

Performance West Physical Therapy
1551 Renaissance Towne Dr, Ste 350,
Bountiful, UT 84010-7667
(801) 295-3553
(801) 295-3599

Map and Direction




Healthcare Provider's Profile

Full NamePerformance West Physical Therapy
TypeFacility
SpecialityPhysical Therapist
Location1551 Renaissance Towne Dr, Bountiful, Utah
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1720148240
  • Provider Enumeration Date: 12/12/2006
  • Last Update Date: 11/16/2012
  Medicare PECOS Information:
  • PECOS PAC ID: 4789649047
  • Enrollment ID: O20041129000296

Medical Identifiers

Medical identifiers for Performance West Physical Therapy such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1720148240NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225100000XPhysical Therapist 200631198 (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. Performance West Physical Therapy acts as a billing entity for following providers:
Provider NameAmanda B Thompson
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1588650196
PECOS PAC ID: 1951326305
Enrollment ID: I20051014000841
Provider NameCurtis B Jolley
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1548261431
PECOS PAC ID: 6406811777
Enrollment ID: I20060126000064
Provider NameKim W Reid
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1558362434
PECOS PAC ID: 1153386420
Enrollment ID: I20060131000777
Provider NameStuart C Sondrup
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1790066124
PECOS PAC ID: 6305011313
Enrollment ID: I20111202000190
Provider NameMegan Moss
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1932487899
PECOS PAC ID: 1658639323
Enrollment ID: I20171229002161
Provider NameDereck B Hope
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1881639540
PECOS PAC ID: 8921039660
Enrollment ID: I20180103001717
Provider NameCole Jones
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1710441373
PECOS PAC ID: 4183964315
Enrollment ID: I20191107002746
Provider NameJake Roger Matern
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1730747411
PECOS PAC ID: 4385979202
Enrollment ID: I20200403002090
Provider NameBlake Cope
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1952977050
PECOS PAC ID: 4688072226
Enrollment ID: I20211012001043
Provider NameMckale Mikolajczak
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1427795541
PECOS PAC ID: 9133501828
Enrollment ID: I20220727002578
Provider NameLuke Plaizier
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1528767522
PECOS PAC ID: 0648637520
Enrollment ID: I20230608000501
Provider NameRyan C Despain
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1386338523
PECOS PAC ID: 9436519709
Enrollment ID: I20230718002768

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. Performance West Physical Therapy 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 AddressPractice Location Address
Performance West Physical Therapy
1551 Renaissance Towne Dr, Ste 350,
Bountiful, UT 84010-7667

Ph: (801) 295-3553		Performance West Physical Therapy
1551 Renaissance Towne Dr, Ste 350,
Bountiful, UT 84010-7667

Ph: (801) 295-3553

Reviews and Comments


Physical Therapist in Bountiful, UT

Jaren Weber, DPT
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 74 E 500 S Ste 104, Bountiful, UT 84010
Phone: 801-292-5011    
Mr. Robert Allen Hawkes, MSPT
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 1551 S Renaissance Twn Dr, Suite 420 Sportsmed Physical Therapy, Bountiful, UT 84010
Phone: 801-295-8999    Fax: 801-292-4168
Jessica Elizabeth Sherman, PT, DPT
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 280 N Main St, Bountiful, UT 84010
Phone: 801-397-8700    
Michael Carl Warren, PT
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 74 E 500 S Ste 104, Bountiful, UT 84010
Phone: 801-292-5011    Fax: 801-292-8222
Jessie Balicki,
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 523 N Main St, Bountiful, UT 84010
Phone: 801-951-2273    
Mr. Robert J Larsen, MPT ATG
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 1551 S Renaissance Twn Dr, Suite 420, Bountiful, UT 84010
Phone: 801-295-8999    Fax: 801-292-4168
Mrs. Stephanie Jackson, D.P.T.
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 1551 Renaissance Towne Dr Ste 350, Bountiful, UT 84010
Phone: 801-295-3553    Fax: 801-295-3599

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.