JORDAN M MITCHELL (PT, DPT) – Physical Therapist, NPI 1912552852
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,633 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL
Provider Addresses for JORDAN M MITCHELL (PT, DPT)
21756 STATE ROAD 54 STE 102
LUTZ, FL 335492905
Phone: (727) 475-5540
Fax: (844) 213-8986
Type: Mailing
236 Mohawk Rd
Minneola, FL 347157433
Phone: (352) 404-6908
Fax: (352) 404-6909
Type: Location
South Florida Avenue, Lakeland, Polk County, Florida, 33813, United States
LAKELAND, FL 338132184
Phone: (863) 812-4064
Fax: (855) 497-8449
Type: Location
790 REMINGTON BLVD
BOLINGBROOK, IL 604404909
Phone:
Type: Mailing
822 S AUTO MALL RD
BLOOMINGTON, IN 474015430
Phone: (812) 668-1781
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: 2024-06-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20190916001992 | I | Physical Therapist In Private Practice | FL | TBD |
| I20240607000423 | I | Physical Therapist In Private Practice | IN | 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 | 321 | 28 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 206 | 26 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 105 | 16 | $0 |
| 97162 | Evaluation for physical therapy, typically 30 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 33549)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| Physical Therapist In Private Practice | FL | |
| Physical Therapist In Private Practice | FL | |
| Physical Therapist In Private Practice | FL | |
| - | FL | |
| Physical Therapist In Private Practice | TX |
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