JEREMY SHAKOURI WYDRA – Orthopedic Physical Therapist, NPI 1497480792
Orthopedic Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,982 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MD
Provider Addresses for JEREMY SHAKOURI WYDRA
300 ORGANZA PL
CHULUOTA, FL 327666028
Phone: (407) 733-9097
Type: Mailing
7450 NEW TECHNOLOGY WAY
FREDERICK, MD 217038446
Phone: (410) 989-3833
Type: Location
4040 WINTER GARDEN VINELAND RD
WINTER GARDEN, FL 347879502
Phone: (407) 573-3361
Fax: (407) 395-8309
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: 2023-06-30
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230630003218 | I | Physical Therapist In Private Practice | FL | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 155 | 40 | $0 |
| 97530 | Therapy procedure using functional activities | 124 | 32 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 50 | 25 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 41 | 13 | $0 |
Insurance plans in this area (ZIP 32766)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine, Cardiovascular Disease (Cardiology) | NY | |
| Endocrinology, Internal Medicine | FL | |
| Family Practice | FL | |
| Physical Therapist In Private Practice | FL | |
| - | FL | |
| - | FL | |
| Nurse Practitioner | FL | |
| Qualified Speech Language Pathologist | FL | |
| Cardiovascular Disease (Cardiology), Internal Medicine | FL | |
| - | FL |
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