KRYSTAL BRIDGEWATER (PT, DPT) – Physical Therapist, NPI 1215355987

KRYSTAL BRIDGEWATER (PT, DPT) is a healthcare provider. based in Destin, Florida. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 9976 (CT). The NPI Number for KRYSTAL BRIDGEWATER (PT, DPT) is 1215355987

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
KRYSTAL BRIDGEWATER (PT, DPT)
NPI
1215355987
Phone
(239) 216-3874
Address
955 Airport Rd
Enumeration Date
31 March 2014
Last Update Date
17 March 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2394013144
Graduation Year
2013 (13 years ago)
PAC ID
7810350204
Group Practice PAC ID
9133624554
Professional Enrollment ID
I20230901000966
Address ID
FL341142503NA8480XRDXX500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:12State licenses:3Digital endpointsOther names

4,633 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL

Provider Addresses for KRYSTAL BRIDGEWATER (PT, DPT)

  • 955 Airport Rd

    Apt 1123

    Destin, FL 325412815

    Phone: (239) 216-3874

    Type: Location

  • 4521 12TH ST NE

    NAPLES, FL 341200474

    Phone: (239) 216-1475

    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: 2023-09-01

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
I20230901000966IPhysical Therapist In Private PracticeFLTBD

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 activities47327$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes35223$0
97116Therapy procedure for walking training, each 15 minutes25224$0
97164Re-evaluation for physical therapy, typically 20 minutes1311$0
View full utilization report →

Insurance plans in this area (ZIP 32541)

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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: 9133624554View full group profile
NameSpecialtyState
Qualified Speech Language PathologistFL
Physical Therapist In Private PracticeFL
Occupational Therapist In Private PracticeNY

Reviews

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Frequently asked questions

Can I verify KRYSTAL BRIDGEWATER (PT, DPT) with an NPI only?
You can start verification with NPI 1215355987 for KRYSTAL BRIDGEWATER (PT, DPT), then check state licensing separately.
Does the file indicate KRYSTAL BRIDGEWATER (PT, DPT) is practicing under active NPI?
Directory data currently reports KRYSTAL BRIDGEWATER (PT, DPT) as active.
What taxonomy line describes KRYSTAL BRIDGEWATER (PT, DPT)?
For research purposes, treat KRYSTAL BRIDGEWATER (PT, DPT) as Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Does KRYSTAL BRIDGEWATER (PT, DPT) list a practice location?
Patients near Destin, Florida may find KRYSTAL BRIDGEWATER (PT, DPT) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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