TYLER JACKSON (DPT) – Physical Therapist, NPI 1023489796

TYLER JACKSON (DPT) is a healthcare provider. based in Cupertino, California. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 43079 (CA). The NPI Number for TYLER JACKSON (DPT) is 1023489796

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
TYLER JACKSON (DPT)
NPI
1023489796
Phone
Not provided
Address
20823 STEVENS CREEK BLVD
Enumeration Date
7 October 2015
Last Update Date
7 October 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4082526076
Graduation Year
2015 (11 years ago)
PAC ID
3173823275
Group Practice PAC ID
0244335180
Professional Enrollment ID
I20151120002430
Address ID
CA950142112CU20823BLVD401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

9,448 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CA

Provider Addresses for TYLER JACKSON (DPT)

  • 20823 STEVENS CREEK BLVD

    CUPERTINO, CA 950142108

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-11-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20151120002430IPhysical Therapist In Private PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes15836$0
97140Therapy procedure using manual technique, each 15 minutes8830$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes3615$0
View full utilization report →

Insurance plans in this area (ZIP 95014)

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Provider's Procedures

TYLER JACKSON (DPT) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYCA97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes21138
PHYSICAL THERAPYCA97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes16337

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0244335180View full group profile
NameSpecialtyState
-CA
Physical Therapist In Private PracticeCA
-CA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeOR

Reviews

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Frequently asked questions

What is the registry number for TYLER JACKSON (DPT)?
The registry entry for TYLER JACKSON (DPT) shows NPI 1023489796.
Quick check: is TYLER JACKSON (DPT) active?
Public NPPES data shows TYLER JACKSON (DPT) with an active NPI status right now.
How should patients interpret TYLER JACKSON (DPT)'s specialty?
The extract shows Physical Therapist for TYLER JACKSON (DPT). Clinical services aligned with this taxonomy classification.
Is TYLER JACKSON (DPT) tied to Cupertino, California?
If you are local to Cupertino, California, TYLER JACKSON (DPT) may be relevant to your search.
Who maintains TYLER JACKSON (DPT)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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