Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tyler Ellis

Individual provider Physical Therapist · NPI 1164863882

Tyler Ellis is a Physical Therapist in Private Practice in Salt Lake City, Utah. Qualified in 2013, 13 years ago. Practices with Mountain Land Rehabilitation LLC, a 203-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
13
Licensed in
UT
In the registry since
2013
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Practice location Address checks out

1952 E 7000 S
Salt Lake City, UT 84121-6877
Phone: (801) 942-3311
Fax: (801) 495-5303
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 8706957-8016 (UT)

Record details

NPI number1164863882
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 10, 2013
Last updated in NPPESJuly 10, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Mountain Land Rehabilitation Llc — 203 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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