KAELAN PATRICK ELLIS (DPT) – Physical Therapist, NPI 1407349558

KAELAN PATRICK ELLIS (DPT) is a healthcare provider. based in San bernardino, California. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. The NPI Number for KAELAN PATRICK ELLIS (DPT) is 1407349558

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
KAELAN PATRICK ELLIS (DPT)
NPI
1407349558
Phone
(909) 567-2221
Address
275 W HOSPITALITY LN STE 103
Enumeration Date
13 June 2018
Last Update Date
12 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9095672221
Graduation Year
2018 (8 years ago)
PAC ID
8325382153
Group Practice PAC ID
3274899315
Professional Enrollment ID
I20210727003923
Address ID
CA924083238SA275XXLNXX403
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness85
Years active:8State licenses:0Digital endpointsOther names

9,522 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CA

Provider Addresses for KAELAN PATRICK ELLIS (DPT)

  • 275 W HOSPITALITY LN STE 103

    SAN BERNARDINO, CA 924083238

    Phone: (909) 567-2221

    Type: Mailing

  • 25915 BARTON RD STE 206

    LOMA LINDA, CA 923543818

    Phone: (909) 686-6903

    Fax: (909) 796-0550

    Type: Location

  • Hancock Avenue, Murrieta, Riverside County, California, 92563, United States

    MURRIETA, CA 925625988

    Phone: (951) 698-7720

    Type: Mailing

  • 1329 BARTON RD

    STE B

    REDLANDS, CA 923734419

    Phone: (951) 698-7720

    Type: Mailing

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: 2021-07-27

PECOS data refreshed: 2026-06-15

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
I20210727003923IPhysical 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 minutes36745$0
97530Therapy procedure using functional activities6319$0
97140Therapy procedure using manual technique, each 15 minutes4315$0
97162Evaluation for physical therapy, typically 30 minutes3231$0
97164Re-evaluation for physical therapy, typically 20 minutes2018$0
View full utilization report →

Insurance plans in this area (ZIP 92408)

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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: 3274899315View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Occupational Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Occupational Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Occupational Therapist In Private PracticeCA

Reviews

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Frequently asked questions

What identifier follows KAELAN PATRICK ELLIS (DPT) across health systems?
The NPI 1407349558 uniquely identifies KAELAN PATRICK ELLIS (DPT) in U.S. healthcare data.
Is KAELAN PATRICK ELLIS (DPT)'s NPI status active today?
Active status means KAELAN PATRICK ELLIS (DPT)'s NPI record is not deactivated in the public file.
Which specialty label fits KAELAN PATRICK ELLIS (DPT)?
NPPES ties KAELAN PATRICK ELLIS (DPT) to Physical Therapist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit KAELAN PATRICK ELLIS (DPT) in San Bernardino, California?
For routing, start with San Bernardino, California for KAELAN PATRICK ELLIS (DPT), then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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