RICHARD EDWARD NYBERG (P.T.) – Orthopedic Physical Therapist, NPI 1366630345

RICHARD EDWARD NYBERG (P.T.) is a healthcare provider. based in Tucker, Georgia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials P.T.. They hold a License No. 0897 (GA). The NPI Number for RICHARD EDWARD NYBERG (P.T.) is 1366630345

Main info

Male
51 Years Of Experience
Accepts Medicare Assignment
Name
RICHARD EDWARD NYBERG (P.T.)
NPI
1366630345
Phone
(770) 491-6004
Address
2191 NORTHLAKE PKWY
Enumeration Date
4 October 2007
Last Update Date
4 October 2007

Doctor Profile

Medical School Name
STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
Secondary Phone
7704916004
Graduation Year
1975 (51 years ago)
PAC ID
3971770611
Group Practice PAC ID
5395711725
Professional Enrollment ID
I20120119000802
Address ID
GA300845246TU1901XRDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

2,871 PHYSICAL THERAPIST IN PRIVATE PRACTICE in GA

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Provider Addresses for RICHARD EDWARD NYBERG (P.T.)

  • 1-877-9-TakeAway, LLC., 2191 11-E, Northlake Parkway, Tucker, DeKalb County, Georgia, 30084, United States

    SUITE 31

    TUCKER, GA 300844166

    Phone: (770) 491-6004

    Fax: (770) 723-0872

    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: 2012-01-19

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
I20120119000802IPhysical Therapist In Private PracticeGATBD

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
97140Therapy procedure using manual technique, each 15 minutes2,15586$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes1,49190$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes1,06493$0
97530Therapy procedure using functional activities40284$0
97164Re-evaluation for physical therapy, typically 20 minutes10465$0
View full utilization report →

Insurance plans in this area (ZIP 30084)

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Provider's Procedures

RICHARD EDWARD NYBERG (P.T.) 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 THERAPYGA97001Physical therapy evaluation1818
PHYSICAL THERAPYGA97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes90783

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: 5395711725View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeAL
Physical Therapist In Private PracticeGA
-GA
-GA

Reviews

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Frequently asked questions

Is there an official ID for RICHARD EDWARD NYBERG (P.T.) in U.S. healthcare records?
The official identifier for RICHARD EDWARD NYBERG (P.T.) is NPI 1366630345.
Is RICHARD EDWARD NYBERG (P.T.) still an active registrant?
RICHARD EDWARD NYBERG (P.T.) carries an active NPI according to the public dataset.
What kind of doctor is RICHARD EDWARD NYBERG (P.T.)?
RICHARD EDWARD NYBERG (P.T.) is associated with Orthopedic Physical Therapist in the directory — Clinical services aligned with this taxonomy classification.
Is RICHARD EDWARD NYBERG (P.T.) located near Tucker?
RICHARD EDWARD NYBERG (P.T.) currently maps to Tucker, Georgia in this extract.
Can I trust this NPI listing for RICHARD EDWARD NYBERG (P.T.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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