DR. TY PETERSON (DPT) – Physical Therapist, NPI 1225406226

DR. TY PETERSON (DPT) is a healthcare provider. based in Panama city, Florida. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 30355 (FL). The NPI Number for DR. TY PETERSON (DPT) is 1225406226

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
DR. TY PETERSON (DPT)
NPI
1225406226
Phone
(850) 691-4188
Address
2011 HARRISON AVE
Enumeration Date
8 September 2015
Last Update Date
30 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8506914188
Graduation Year
2015 (11 years ago)
PAC ID
9830633791
Group Practice PAC ID
4284532755
Professional Enrollment ID
I20240702002495
Address ID
FL324054545PA2011XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:10State licenses:2Digital endpointsOther names

4,636 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL

Provider Addresses for DR. TY PETERSON (DPT)

  • 2011 HARRISON AVE

    PANAMA CITY, FL 324054545

    Phone: (850) 691-4188

    Type: Location

  • 3116 E 3RD ST

    PANAMA CITY, FL 324015643

    Phone:

    Type: Mailing

  • 3801 E HIGHWAY 98

    PORT ST JOE, FL 324565318

    Phone: (850) 229-5600

    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: 2024-07-02

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
I20240702002495IPhysical 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.

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

Insurance plans in this area (ZIP 32405)

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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: 4284532755View full group profile
NameSpecialtyState
-FL
Physical Therapist In Private PracticeNY
Orthopedic SurgeryFL
Physical Therapist In Private PracticeFL
Nurse PractitionerFL
-FL
Occupational Therapist In Private PracticeFL
Orthopedic SurgeryFL
Nurse PractitionerFL
Physical Therapist In Private PracticeFL

Reviews

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Frequently asked questions

What identifier follows DR. TY PETERSON (DPT) across health systems?
The NPI 1225406226 uniquely identifies DR. TY PETERSON (DPT) in U.S. healthcare data.
Is DR. TY PETERSON (DPT) currently accepting referrals based on NPI status?
Registry metadata lists DR. TY PETERSON (DPT) as active.
What does the directory say DR. TY PETERSON (DPT) does?
Insurance directories may phrase it differently, but here DR. TY PETERSON (DPT) maps to Physical Therapist. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. TY PETERSON (DPT)?
DR. TY PETERSON (DPT) shows a connection to Panama City, Florida in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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