LOGAN KEEDY – Physical Therapist, NPI 1790477719

LOGAN KEEDY is a healthcare provider. based in Lutz, Florida. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. The NPI Number for LOGAN KEEDY is 1790477719

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
LOGAN KEEDY
NPI
1790477719
Phone
Not provided
Address
21756 STATE ROAD 54 STE 102
Enumeration Date
26 May 2023
Last Update Date
26 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8138058105
Graduation Year
2023 (3 years ago)
PAC ID
7719341163
Group Practice PAC ID
9931224367
Professional Enrollment ID
I20230918004162
Address ID
FL336061812TA1501XSTXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness75
Years active:3State licenses:0Digital endpointsOther names

4,636 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL

Provider Addresses for LOGAN KEEDY

  • 21756 STATE ROAD 54 STE 102

    LUTZ, FL 335492905

    Phone:

    Type: Mailing

  • 1501 W CLEVELAND ST STE 220

    TAMPA, FL 336061812

    Phone: (813) 805-8105

    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: 2023-09-18

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
I20230918004162IPhysical 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 minutes26416$0
97140Therapy procedure using manual technique, each 15 minutes2111$0
97161Evaluation for physical therapy, typically 20 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 33549)

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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: 9931224367View full group profile
NameSpecialtyState
-FL
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
-FL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL

Reviews

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Frequently asked questions

Where can patients find LOGAN KEEDY's NPI?
You can confirm LOGAN KEEDY with NPI 1790477719; it appears in the national provider directory.
Is LOGAN KEEDY's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize LOGAN KEEDY's specialty in plain language?
Clinically, the directory lists LOGAN KEEDY with Physical Therapist. Clinical services aligned with this taxonomy classification.
What location metadata exists for LOGAN KEEDY?
The page summarizes Lutz, Florida for LOGAN KEEDY; expand the address list for detail.
What if Lutz, Florida seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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