MR. KIM ENEBERG (PT) – Physical Therapist, NPI 1255844916

MR. KIM ENEBERG (PT) is a healthcare provider. based in Saint petersburg, Florida. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. PT35351 (FL). The NPI Number for MR. KIM ENEBERG (PT) is 1255844916

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
MR. KIM ENEBERG (PT)
NPI
1255844916
Phone
(727) 851-6345
Address
2975 67TH WAY N
Enumeration Date
15 November 2017
Last Update Date
27 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4076052321
Graduation Year
2013 (13 years ago)
PAC ID
8325307945
Group Practice PAC ID
0042252140
Professional Enrollment ID
I20210317000213
Address ID
FL336134709TA3500XAVEX415
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness85
Years active:8State licenses:1Digital endpointsOther names

4,633 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL

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Provider Addresses for MR. KIM ENEBERG (PT)

  • 2975, 67th Way North, Holiday Park, Saint Petersburg, Pinellas County, Florida, 33710, United States

    SAINT PETERSBURG, FL 337103136

    Phone: (727) 851-6345

    Type: Location

  • 336 BROAD ST # 203

    ROME, GA 301613006

    Phone: (727) 281-8940

    Fax: (727) 281-8943

    Type: Mailing

  • 1345 W BAY DR

    LARGO, FL 337702282

    Phone: (727) 281-8940

    Fax: (727) 281-8943

    Type: Location

  • 3500 E FLETCHER AVE STE 133

    TAMPA, FL 336134709

    Phone: (407) 605-2321

    Fax: (407) 671-4155

    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: 2021-03-17

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
I20210317000213IPhysical 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 33710)

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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: 0042252140View full group profile
NameSpecialtyState
P O D I A T R YMI
P O D I A T R YNJ
P O D I A T R YFL
P O D I A T R YFL
P O D I A T R YFL
P O D I A T R YFL
P O D I A T R YKY
P O D I A T R YFL
P O D I A T R YFL
P O D I A T R YFL

Reviews

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Frequently asked questions

Does MR. KIM ENEBERG (PT) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MR. KIM ENEBERG (PT) uses 1255844916.
Does CMS list MR. KIM ENEBERG (PT) as active?
Yes — MR. KIM ENEBERG (PT) is active in the NPI listing used on this page.
What is MR. KIM ENEBERG (PT) best known for clinically?
Directory data describes MR. KIM ENEBERG (PT) with Physical Therapist. Clinical services aligned with this taxonomy classification.
Where is MR. KIM ENEBERG (PT) based?
MR. KIM ENEBERG (PT) is tied to Saint Petersburg, Florida in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
6 practice locations appear in the available data.

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