BRENT VANDERZYL (ATC, LAT) – Athletic Trainer, NPI 1780816512

BRENT VANDERZYL (ATC, LAT) is a healthcare provider. based in Kissimmee, Florida. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials ATC, LAT. They hold a License No. AL2701 (FL). The NPI Number for BRENT VANDERZYL (ATC, LAT) is 1780816512

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
BRENT VANDERZYL (ATC, LAT)
NPI
1780816512
Phone
(407) 791-2366
Address
190 E CEDARWOOD CIR
Enumeration Date
12 August 2009
Last Update Date
12 August 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5613505968
Graduation Year
2013 (13 years ago)
PAC ID
9830325489
Group Practice PAC ID
0143542860
Professional Enrollment ID
I20131204000522
Address ID
FL334462340DE7201XBLVD400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:16State licenses:1Digital endpointsOther names

4,636 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL

Provider Addresses for BRENT VANDERZYL (ATC, LAT)

  • 190 E CEDARWOOD CIR

    KISSIMMEE, FL 347439070

    Phone: (407) 791-2366

    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: 2013-12-04

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
I20131204000522IPhysical 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
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes4,462132$0
97140Therapy procedure using manual technique, each 15 minutes697124$0
97530Therapy procedure using functional activities623119$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes618108$0
97116Therapy procedure for walking training, each 15 minutes15761$0
View full utilization report →

Insurance plans in this area (ZIP 34743)

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Provider's Procedures

BRENT VANDERZYL (ATC, LAT) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYFL97001Physical therapy evaluation11193
PHYSICAL THERAPYFL97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes61197

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: 0143542860View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeMD
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
-FL

Reviews

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Frequently asked questions

What is the 10-digit NPI for BRENT VANDERZYL (ATC, LAT)?
BRENT VANDERZYL (ATC, LAT) — NPI 1780816512 — is the standard way to identify this listing.
Is BRENT VANDERZYL (ATC, LAT) still practicing?
BRENT VANDERZYL (ATC, LAT) is currently listed as active in the public NPI registry.
What is BRENT VANDERZYL (ATC, LAT)'s primary classification?
Athletic Trainer is the headline specialty for BRENT VANDERZYL (ATC, LAT) here. Clinical services aligned with this taxonomy classification.
Does BRENT VANDERZYL (ATC, LAT) list a practice location?
Patients near Kissimmee, Florida may find BRENT VANDERZYL (ATC, LAT) 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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