MRS. KRISTIN TYSE SHADDUCK (PT) – Physical Therapist, NPI 1255348462

MRS. KRISTIN TYSE SHADDUCK (PT) is a healthcare provider. based in Los altos, California. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 11542 (CA). The NPI Number for MRS. KRISTIN TYSE SHADDUCK (PT) is 1255348462

Main info

Female
45 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KRISTIN TYSE SHADDUCK (PT)
NPI
1255348462
Phone
(650) 947-9646
Address
794 ALTOS OAKS DR
Enumeration Date
1 August 2006
Last Update Date
14 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6509479646
Graduation Year
1981 (45 years ago)
PAC ID
6204851801
Group Practice PAC ID
6507259538
Professional Enrollment ID
I20051012001148
Address ID
CA940245401LO794XXDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

9,448 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CA

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Provider Addresses for MRS. KRISTIN TYSE SHADDUCK (PT)

  • 794, Altos Oaks Drive, Loyola Corners, Los Altos, Santa Clara County, California, 94024, United States

    LOS ALTOS, CA 940246013

    Phone: (650) 947-9646

    Fax: (650) 947-9566

    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: 2005-10-12

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
I20051012001148IPhysical 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
97140Therapy procedure using manual technique, each 15 minutes1,992109$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes1,430106$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care37450$0
97530Therapy procedure using functional activities19952$0
97161Evaluation for physical therapy, typically 20 minutes7162$0
View full utilization report →

Insurance plans in this area (ZIP 94024)

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Provider's Procedures

MRS. KRISTIN TYSE SHADDUCK (PT) 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 THERAPYCA97001Physical therapy evaluation6260

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: 6507259538View full group profile
NameSpecialtyState
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 PracticeTN
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA

Reviews

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Frequently asked questions

Does MRS. KRISTIN TYSE SHADDUCK (PT) have a public NPI I can cite?
Public records show MRS. KRISTIN TYSE SHADDUCK (PT) under NPI 1255348462.
Is MRS. KRISTIN TYSE SHADDUCK (PT)'s NPI status active today?
Active status means MRS. KRISTIN TYSE SHADDUCK (PT)'s NPI record is not deactivated in the public file.
What does the directory say MRS. KRISTIN TYSE SHADDUCK (PT) does?
Insurance directories may phrase it differently, but here MRS. KRISTIN TYSE SHADDUCK (PT) maps to Physical Therapist. Clinical services aligned with this taxonomy classification.
What city is tied to MRS. KRISTIN TYSE SHADDUCK (PT)?
The directory associates MRS. KRISTIN TYSE SHADDUCK (PT) with Los Altos, California. Check all listed addresses for suites or satellite offices.
Why is information missing for MRS. KRISTIN TYSE SHADDUCK (PT)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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