JEANNETTE ELAINE GRACE (P.T.) – Orthopedic Physical Therapist, NPI 1114903192

JEANNETTE ELAINE GRACE (P.T.) is a healthcare provider. based in Santa rosa, California. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials P.T.. They hold a License No. PT21833 (CA). The NPI Number for JEANNETTE ELAINE GRACE (P.T.) is 1114903192

Main info

Female
30 Years Of Experience
Accepts Medicare Assignment
Name
JEANNETTE ELAINE GRACE (P.T.)
NPI
1114903192
Phone
(707) 571-7615
Address
795 FARMERS LN
Enumeration Date
21 December 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7075232848
Graduation Year
1996 (30 years ago)
PAC ID
9739274291
Group Practice PAC ID
6002261088
Professional Enrollment ID
I20070928000666
Address ID
CA954017120SA1400XAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

9,448 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CA

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Provider Addresses for JEANNETTE ELAINE GRACE (P.T.)

  • 795, Farmers Lane, Santa Rosa, Sonoma County, California, 95405, United States

    SUITE 10

    SANTA ROSA, CA 954056718

    Phone: (707) 571-7615

    Fax: (707) 571-8601

    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: 2007-09-28

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
I20070928000666IPhysical 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
97530Therapy procedure using functional activities1,61648$0
97163Evaluation for physical therapy, typically 45 minutes2221$0
97162Evaluation for physical therapy, typically 30 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 95405)

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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: 6002261088View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA

Reviews

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Frequently asked questions

What unique ID ties claims to JEANNETTE ELAINE GRACE (P.T.)?
NPI 1114903192 is assigned to JEANNETTE ELAINE GRACE (P.T.) under the national enumeration system.
Is JEANNETTE ELAINE GRACE (P.T.) active in the national directory?
JEANNETTE ELAINE GRACE (P.T.)'s public NPI profile is in an active state.
Can you summarize JEANNETTE ELAINE GRACE (P.T.)'s specialty in plain language?
Clinically, the directory lists JEANNETTE ELAINE GRACE (P.T.) with Orthopedic Physical Therapist. Clinical services aligned with this taxonomy classification.
Where is JEANNETTE ELAINE GRACE (P.T.)'s primary listing?
We display Santa Rosa, California because that is what the record indicates for JEANNETTE ELAINE GRACE (P.T.).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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