JUSTIN PODELL (PT, DPT, MED, ATC) – Physical Therapist, NPI 1558738773

JUSTIN PODELL (PT, DPT, MED, ATC) is a healthcare provider. based in Jacksonville, Florida. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT, MED, ATC. They hold a License No. 30375 (FL). The NPI Number for JUSTIN PODELL (PT, DPT, MED, ATC) is 1558738773

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
JUSTIN PODELL (PT, DPT, MED, ATC)
NPI
1558738773
Phone
(904) 854-2090
Address
10423 CENTURION PKWY N
Enumeration Date
24 August 2015
Last Update Date
24 August 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7036987888
Graduation Year
2015 (11 years ago)
PAC ID
3072099134
Group Practice PAC ID
5193157154
Professional Enrollment ID
I20260108003265
Address ID
VA220312228FA8500XAVEX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

4,633 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL

Provider Addresses for JUSTIN PODELL (PT, DPT, MED, ATC)

  • 10423 CENTURION PKWY N

    JACKSONVILLE, FL 322560527

    Phone: (904) 854-2090

    Fax: (904) 854-2093

    Mailing address matches the actual address.

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: 2026-01-08

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
I20260108003265IPhysical Therapist In Private PracticeDCTBD

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 32256)

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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: 5193157154View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeNC
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeNC
-IL
-VA

Reviews

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Frequently asked questions

What unique ID ties claims to JUSTIN PODELL (PT, DPT, MED, ATC)?
NPI 1558738773 is assigned to JUSTIN PODELL (PT, DPT, MED, ATC) under the national enumeration system.
Is JUSTIN PODELL (PT, DPT, MED, ATC)'s NPI currently valid?
The extract we use shows JUSTIN PODELL (PT, DPT, MED, ATC) as active.
What kind of provider is JUSTIN PODELL (PT, DPT, MED, ATC)?
The page reflects Physical Therapist for JUSTIN PODELL (PT, DPT, MED, ATC). Clinical services aligned with this taxonomy classification.
What location shows for JUSTIN PODELL (PT, DPT, MED, ATC)?
We surface Jacksonville, Florida for JUSTIN PODELL (PT, DPT, MED, ATC) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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