JONATHAN LYLE ANDERSEN (PT) – Physical Therapist, NPI 1346326550

JONATHAN LYLE ANDERSEN (PT) is a healthcare provider. based in Modesto, California. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 33070 (CA). The NPI Number for JONATHAN LYLE ANDERSEN (PT) is 1346326550

Main info

Male
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
JONATHAN LYLE ANDERSEN (PT)
NPI
1346326550
Phone
(209) 342-2300
Address
4301 N STAR WAY
Enumeration Date
31 October 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2095494626
Graduation Year
2006 (20 years ago)
PAC ID
7618976929
Group Practice PAC ID
3678520244
Professional Enrollment ID
I20061214000532
Address ID
CA953552704MO1917XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

9,449 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CA

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Provider Addresses for JONATHAN LYLE ANDERSEN (PT)

  • 4301 N STAR WAY

    MODESTO, CA 953569262

    Phone: (209) 342-2300

    Fax: (209) 524-4240

    Type: Mailing

  • 3500, Coffee Road, Modesto, Stanislaus County, California, 95355, United States

    SUITE 3

    MODESTO, CA 953551344

    Phone: (209) 342-2300

    Fax: (209) 524-4240

    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: 2006-12-14

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
I20061214000532IPhysical 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 minutes5,501278$0
97113Therapy procedure using water pool to exercises, each 15 minutes2,11370$0
97140Therapy procedure using manual technique, each 15 minutes1,586185$0
97161Evaluation for physical therapy, typically 20 minutes200191$0
97530Therapy procedure using functional activities11622$0
View full utilization report →

Insurance plans in this area (ZIP 95356)

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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: 3678520244View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeCA
-CA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Occupational Therapist In Private PracticeCA
Occupational Therapist In Private PracticeCA
Occupational Therapist In Private PracticeCA
Occupational Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA

Reviews

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Frequently asked questions

Does JONATHAN LYLE ANDERSEN (PT) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — JONATHAN LYLE ANDERSEN (PT) uses 1346326550.
Is JONATHAN LYLE ANDERSEN (PT) listed as active for patients and plans?
The listing shows JONATHAN LYLE ANDERSEN (PT) as active in the NPI system.
What taxonomy line describes JONATHAN LYLE ANDERSEN (PT)?
For research purposes, treat JONATHAN LYLE ANDERSEN (PT) as Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect JONATHAN LYLE ANDERSEN (PT) on a map?
Expect Modesto, California as a primary anchor for JONATHAN LYLE ANDERSEN (PT) unless the record lists multiple sites.
Why does JONATHAN LYLE ANDERSEN (PT) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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