NATHAN SPENCER (PT) – Physical Therapy Assistant, NPI 1063106433

NATHAN SPENCER (PT) is a healthcare provider. based in Eagle, Idaho. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. PT-8584 (ID). The NPI Number for NATHAN SPENCER (PT) is 1063106433

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
NATHAN SPENCER (PT)
NPI
1063106433
Phone
(208) 939-9594
Address
645 E STATE ST STE 101
Enumeration Date
7 June 2023
Last Update Date
7 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2089399594
Graduation Year
2023 (3 years ago)
PAC ID
3779942701
Group Practice PAC ID
9931010014
Professional Enrollment ID
I20230707003298
Address ID
ID836165915EA645XXSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

834 PHYSICAL THERAPIST IN PRIVATE PRACTICE in ID

Provider Addresses for NATHAN SPENCER (PT)

  • 645 E STATE ST STE 101

    EAGLE, ID 836165915

    Phone: (208) 939-9594

    Fax: (208) 939-9828

    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: 2023-07-07

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
I20230707003298IPhysical Therapist In Private PracticeIDTBD

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
97530Therapy procedure using functional activities3611$0
View full utilization report →

Insurance plans in this area (ZIP 83616)

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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: 9931010014View full group profile
NameSpecialtyState
-ID
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeMD
Physical Therapist In Private PracticeND
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeID
-AZ
Physical Therapist In Private PracticeID
-ID

Reviews

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Frequently asked questions

Can I cross-check NATHAN SPENCER (PT) using NPI 1063106433?
NPI 1063106433 belongs to NATHAN SPENCER (PT); compare other details if you need extra assurance.
Is NATHAN SPENCER (PT) still an active registrant?
NATHAN SPENCER (PT) carries an active NPI according to the public dataset.
What kind of doctor is NATHAN SPENCER (PT)?
NATHAN SPENCER (PT) is associated with Physical Therapy Assistant in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with NATHAN SPENCER (PT)?
Directory geography for NATHAN SPENCER (PT) centers on Eagle, Idaho.
When was this NPI issued?
Enumeration for NATHAN SPENCER (PT) is noted as June 7, 2023 where the registry provides it.

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