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EVAN BURGESS DPT
NPI 1386176071
Physical Therapist - Orthopedic in Salt Lake City, UT

Active since March 31, 2017Accepts Medicare Assignment
1685 W 2200 S, SALT LAKE CITY, UT 84119(801) 887-5455 Get Directions Write a Review

NPPES record last updated: March 31, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Evan Burgess Dpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVAN BURGESS DPT (NPI 1386176071) is an individual orthopedic provider in Salt Lake City, Utah, licensed in Utah (10197781-2401) and active in the NPI registry since March 2017. He is a graduate of Other (2016).

NPPES Registry Identity

NPI1386176071
Entity TypeIndividualMale
Primary Taxonomy2251X0800X
Provider Legal NameEVAN BURGESSCredential: DPT
Location Address1685 W 2200 SSalt Lake City, UT 84119-1456
Mailing Address33 Lost Creek Ln, 403Murray, UT 84107-7964 · (248) 225-3729
Phone(801) 887-5455
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateMarch 31, 2017
✔ NPI 1386176071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · OrthopedicRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251X0800X
License✔ Licensed in UT · 10197781-2401
Definition
A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.
1685 W 2200 S, Salt Lake City, UT 84119
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Evan Burgess Dpt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527503515
PECOS Enrollment IDI20240715001803

Medicare Billing Reassignment

Medicare enrollment records show Evan Burgess reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Utah Luna Care Physical Therapy LLC
9.0 mi
Physical Therapist
159 W BROADWAY STE 200
Salt Lake City, UT 84101
  • Reassigned Medicare billing, Utah enrollment
  • 19 clinicians in this Medicare group
NPI 1437802246 (866) 525-3175

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARIE DUFRESNE BAMBO PT
Physical Therapist
1685 W 2200 S
SALT LAKE CITY, UT 84119
Salt Lake County (801) 887-5455
IHC HEALTH SERVICES INC
Preventive Medicine (Preventive Medicine/Occupational Environmental Medicine)
1685 W 2200 S
SALT LAKE CITY, UT 84119
Salt Lake County (801) 972-8850
SARAH SCOVILLE PA-C
Physician Assistant (Medical)
1685 W 2200 S
SALT LAKE CITY, UT 84119
Salt Lake County (801) 972-8850
MARIYA NIKOLAEVA
Physician Assistant
1685 W 2200 S
SALT LAKE CITY, UT 84119
Salt Lake County (801) 478-7705
IHC HEALTH SERVICES INC
Clinic/Center (Rehabilitation)
1685 W 2200 S
SALT LAKE CITY, UT 84119
Salt Lake County (801) 887-5455
KATIE NICOLE SAMUELS PT
Physical Therapist
1685 W 2200 S
SALT LAKE CITY, UT 84119
Salt Lake County (801) 478-7780
EKATERINA PARKINSON DPT
Specialist
1685 W 2200 S
SALT LAKE CITY, UT 84119
Salt Lake County (801) 887-5455
DON REID MERKLEY APRN
Nurse Practitioner (Occupational Health)
1685 W 2200 S
SALT LAKE CITY, UT 84119
Salt Lake County (801) 972-8850

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evan Burgess's NPI number?

The NPI number for Evan Burgess is 1386176071. It was assigned to this individual provider in the NPPES registry on March 31, 2017.

Where is Evan Burgess located?

Evan Burgess practices at 1685 W 2200 S, Salt Lake City, UT 84119. The listed phone number is (801) 887-5455.

What is Evan Burgess's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.

Is Evan Burgess enrolled in Medicare?

Yes. Evan Burgess is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Evan Burgess's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Evan Burgess reassigns Medicare benefits to Utah Luna Care Physical Therapy LLC (Salt Lake City, UT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Evan Burgess's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Evan Burgess was last updated on March 31, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.