NOAH DICKERSON (PT) – Physical Medicine & Rehabilitation Physician, NPI 1245015338

NOAH DICKERSON (PT) is a healthcare provider. based in Oakland, California. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 304425 (CA). The NPI Number for NOAH DICKERSON (PT) is 1245015338

Main info

Male
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
NOAH DICKERSON (PT)
NPI
1245015338
Phone
(530) 215-6424
Address
459 23RD ST APT 408
Enumeration Date
28 August 2023
Last Update Date
28 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5419669830
Graduation Year
2023 (3 years ago)
PAC ID
7810342326
Group Practice PAC ID
6608924121
Professional Enrollment ID
I20231018000538
Address ID
OR978019417PE46314WAYX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

9,449 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CA

Provider Addresses for NOAH DICKERSON (PT)

  • 459 23RD ST APT 408

    OAKLAND, CA 946122328

    Phone: (530) 215-6424

    Type: Mailing

  • 2322 POWELL ST

    EMERYVILLE, CA 946081738

    Phone: (510) 653-5151

    Type: Location

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: 2025-08-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20231018000538IPhysical Therapist In Private PracticeTXTBD
I20250819003123IPhysical 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94612)

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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: 6608924121View full group profile
NameSpecialtyState
Physical Therapist In Private PracticePA
Physician AssistantOR
Physical Therapist In Private PracticeNV
Registered Dietitian Or Nutrition ProfessionalOR
Nurse PractitionerWA
-OR
Clinical Social WorkerOR
-OR
P O D I A T R YOH
Family PracticeOR

Reviews

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Frequently asked questions

Does NOAH DICKERSON (PT) have a public NPI I can cite?
Public records show NOAH DICKERSON (PT) under NPI 1245015338.
Does the public listing show NOAH DICKERSON (PT) as active?
NOAH DICKERSON (PT)'s NPI record reflects an active status in NPPES.
Which specialty label fits NOAH DICKERSON (PT)?
NPPES ties NOAH DICKERSON (PT) to Physical Medicine & Rehabilitation Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is NOAH DICKERSON (PT) tied to Oakland, California?
If you are local to Oakland, California, NOAH DICKERSON (PT) may be relevant to your search.
Who maintains NOAH DICKERSON (PT)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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