MRS. TINA LOUISE MOON (PT, DPT) – Physical Therapist, NPI 1952535817

MRS. TINA LOUISE MOON (PT, DPT) is a healthcare provider. based in Daytona beach, Florida. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. PT26616 (FL). The NPI Number for MRS. TINA LOUISE MOON (PT, DPT) is 1952535817

Main info

Female
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
MRS. TINA LOUISE MOON (PT, DPT)
NPI
1952535817
Phone
(386) 255-4596
Address
1865 LPGA BLVD
Enumeration Date
7 May 2009
Last Update Date
27 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3862554596
Graduation Year
2011 (15 years ago)
PAC ID
6002342441
Group Practice PAC ID
9335123504
Professional Enrollment ID
I20241210000550
Address ID
FL321272924PO1165XAVEX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:17State licenses:1Digital endpointsOther names

4,636 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL

Provider Addresses for MRS. TINA LOUISE MOON (PT, DPT)

  • 1865 LPGA BLVD

    DAYTONA BEACH, FL 321177108

    Phone: (386) 255-4596

    Fax: (386) 258-3561

    Type: Mailing

  • 1200 LEXINGTON GREEN LN

    SANFORD, FL 327711013

    Phone: (407) 688-0070

    Fax: (407) 688-0071

    Type: Location

  • 1033, Oxford Street, Longwood, Seminole County, Florida, 32750, United States

    LONGWOOD, FL 327505527

    Phone: (407) 782-5606

    Type: Mailing

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: 2024-12-10

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
I20241210000550IPhysical 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32117)

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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: 9335123504View full group profile
NameSpecialtyState
Orthopedic SurgeryFL
Orthopedic SurgeryFL
Orthopedic SurgeryFL
Physical Therapist In Private PracticeFL
Physician AssistantFL
Physical Therapist In Private PracticeFL
Nurse PractitionerFL
Physician AssistantFL
Nurse PractitionerFL
Orthopedic SurgeryFL

Reviews

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Frequently asked questions

Can I verify MRS. TINA LOUISE MOON (PT, DPT) with an NPI only?
You can start verification with NPI 1952535817 for MRS. TINA LOUISE MOON (PT, DPT), then check state licensing separately.
Does the file indicate MRS. TINA LOUISE MOON (PT, DPT) is practicing under active NPI?
Directory data currently reports MRS. TINA LOUISE MOON (PT, DPT) as active.
What taxonomy line describes MRS. TINA LOUISE MOON (PT, DPT)?
For research purposes, treat MRS. TINA LOUISE MOON (PT, DPT) as Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Where is MRS. TINA LOUISE MOON (PT, DPT) based?
MRS. TINA LOUISE MOON (PT, DPT) is tied to Daytona Beach, Florida in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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