Todd Karl Haacke, DPT
NPI 1154023513ActiveIndividual· Physical Therapist· Provo, UT
Physical Therapist (DPT) with Revere Health PC, practicing in Provo, Utah. Medicare paid $31,866 for services to 76 patients in 2024.
Overview
| NPI | 1154023513 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DPT |
| Sole proprietor | Yes |
| NPI issued | Mar 20, 2023 |
| Last updated in NPPES | Jun 7, 2023 |
| Certified by provider | Jun 7, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 11412274-2401 | UT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (UT) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 76 |
|---|---|
| Services billed | 1,780 across 13 procedure codes |
| Paid by Medicare | $31,866 |
Education and affiliations
| Graduation year | 2019 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Revere Health PCProvo, UT · 410 clinicians
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