Andrew Jimin Gottfredson, DPT
NPI 1861230922ActiveIndividual· Physical Therapist· Provo, UT
Physical Therapist (DPT) with Spine Orthopedic and Sports Physical Therapy LLC, practicing in Provo, Utah. Medicare paid $21,416 for services to 54 patients in 2024.
Overview
| NPI | 1861230922 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DPT |
| Sole proprietor | No |
| NPI issued | Jul 15, 2024 |
| Last updated in NPPES | Jul 15, 2024 |
| Certified by provider | Jul 15, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 13980561-2401 | 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 | 54 |
|---|---|
| Services billed | 1,176 across 6 procedure codes |
| Paid by Medicare | $21,416 |
Education and affiliations
| Graduation year | 2023 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Spine Orthopedic and Sports Physical Therapy LLCProvo, UT · 11 clinicians
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