MICHELLE BRODEUR (DPT) – Physical Therapist, NPI 1790176485

MICHELLE BRODEUR (DPT) is a healthcare provider. based in Gainesville, Florida. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. PT30108 (FL). The NPI Number for MICHELLE BRODEUR (DPT) is 1790176485

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
MICHELLE BRODEUR (DPT)
NPI
1790176485
Phone
(352) 376-6300
Address
4113 NW 6TH ST STE C
Enumeration Date
17 February 2015
Last Update Date
14 April 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8602280194
Graduation Year
2014 (12 years ago)
PAC ID
7214253335
Group Practice PAC ID
7214196971
Professional Enrollment ID
I20180516001912
Address ID
CT062371224CO106XXEXXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:11State licenses:1Digital endpointsOther names

4,636 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL

Provider Addresses for MICHELLE BRODEUR (DPT)

  • 4113 NW 6TH ST STE C

    GAINESVILLE, FL 326090731

    Phone: (352) 376-6300

    Fax: (352) 372-0661

    Type: Mailing

  • 106 CT 66

    COLUMBIA, CT 062370623

    Phone: (860) 228-0194

    Type: Location

  • 4113 NW 6th St Ste C

    Gainesville, FL 326090731

    Phone: (352) 376-6300

    Fax: (352) 372-0661

    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: 2018-05-16

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
I20180516001912IPhysical Therapist In Private PracticeCTTBD

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 32609)

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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: 7214196971View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeCT
-CT
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeCT

Reviews

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Frequently asked questions

Can I use this page to confirm MICHELLE BRODEUR (DPT)'s NPI?
Yes. MICHELLE BRODEUR (DPT) is listed with NPI 1790176485 in the public NPI dataset.
Does the file indicate MICHELLE BRODEUR (DPT) is practicing under active NPI?
Directory data currently reports MICHELLE BRODEUR (DPT) as active.
What is MICHELLE BRODEUR (DPT)'s specialty?
The listing groups MICHELLE BRODEUR (DPT) with Physical Therapist. Clinical services aligned with this taxonomy classification.
Does MICHELLE BRODEUR (DPT) list a practice location?
Patients near Gainesville, Florida may find MICHELLE BRODEUR (DPT) in results; validate coverage separately.
Why does MICHELLE BRODEUR (DPT) have multiple addresses?
5 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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