JUSTIN THOMAS KANE (PT) – Physical Therapist, NPI 1114957073
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
834 PHYSICAL THERAPIST IN PRIVATE PRACTICE in ID
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Provider Addresses for JUSTIN THOMAS KANE (PT)
1917, North Lakewood Drive, Blackwell, Coeur d'Alene, Kootenai County, Idaho, 83814, United States
COEUR D ALENE, ID 838142634
Phone: (208) 664-8194
Fax: (208) 667-1847
Type: Mailing
1172, West Hayden Avenue, Hayden, Kootenai County, Idaho, 83835, United States
HAYDEN, ID 838358700
Phone: (208) 762-3332
Fax: (208) 762-4268
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: 2024-01-16
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 |
|---|---|---|---|---|
| I20090507000144 | I | Physical Therapist In Private Practice | ID | TBD |
| I20240116003264 | I | Physical Therapist In Private Practice | WA | 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 | 221 | 17 | $0 |
| 97162 | Evaluation for physical therapy, typically 30 minutes | 13 | 11 | $0 |
Insurance plans in this area (ZIP 83814)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | CA | |
| Registered Dietitian Or Nutrition Professional | ID | |
| Physical Therapist In Private Practice | ID | |
| Physical Therapist In Private Practice | ID | |
| Physical Therapist In Private Practice | WA | |
| Physical Therapist In Private Practice | ID | |
| Physical Therapist In Private Practice | ID | |
| Physical Therapist In Private Practice | ID | |
| Physical Therapist In Private Practice | ID | |
| Physical Therapist In Private Practice | ID |
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