KEVIN DAT VAN (DPT) – Physical Therapist, NPI 1770450124

KEVIN DAT VAN (DPT) is a healthcare provider. based in Roswell, Georgia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 2305217444 (VA). The NPI Number for KEVIN DAT VAN (DPT) is 1770450124

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
KEVIN DAT VAN (DPT)
NPI
1770450124
Phone
(678) 821-2170
Address
875 MANSELL RD STE H
Enumeration Date
21 October 2025
Last Update Date
3 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6788212170
Graduation Year
2025 (1 year ago)
PAC ID
7517457559
Group Practice PAC ID
7618341454
Professional Enrollment ID
I20251107000152
Address ID
GA300764800RO875XXRDXX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness85
Years active:0State licenses:2Digital endpointsOther names

2,870 PHYSICAL THERAPIST IN PRIVATE PRACTICE in GA

Provider Addresses for KEVIN DAT VAN (DPT)

  • 875 MANSELL RD STE H

    ROSWELL, GA 300764800

    Phone: (678) 821-2170

    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: 2025-11-07

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
I20251107000152IPhysical 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.

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

Insurance plans in this area (ZIP 30076)

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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: 7618341454View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA

Reviews

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Frequently asked questions

Can I use this page to confirm KEVIN DAT VAN (DPT)'s NPI?
Yes. KEVIN DAT VAN (DPT) is listed with NPI 1770450124 in the public NPI dataset.
Does CMS list KEVIN DAT VAN (DPT) as active?
Yes — KEVIN DAT VAN (DPT) is active in the NPI listing used on this page.
What is KEVIN DAT VAN (DPT)'s specialty?
The listing groups KEVIN DAT VAN (DPT) with Physical Therapist. Clinical services aligned with this taxonomy classification.
What address line appears for KEVIN DAT VAN (DPT)?
KEVIN DAT VAN (DPT)'s geographic hint is Roswell, Georgia in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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