DR. TREY BRAEDON LANE (DPT) – Physical Therapist, NPI 1487319612

DR. TREY BRAEDON LANE (DPT) is a healthcare provider. based in Nampa, Idaho. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. PT-7506 (ID). The NPI Number for DR. TREY BRAEDON LANE (DPT) is 1487319612

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
DR. TREY BRAEDON LANE (DPT)
NPI
1487319612
Phone
(208) 461-5057
Address
130 S MIDLAND BLVD
Enumeration Date
2 November 2021
Last Update Date
2 November 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2084615057
Graduation Year
2021 (5 years ago)
PAC ID
0446649081
Group Practice PAC ID
0244267029
Professional Enrollment ID
I20211119000953
Address ID
ID836862601NA130XXBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

834 PHYSICAL THERAPIST IN PRIVATE PRACTICE in ID

Provider Addresses for DR. TREY BRAEDON LANE (DPT)

  • 130 S MIDLAND BLVD

    NAMPA, ID 836862601

    Phone: (208) 461-5057

    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: 2021-11-19

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
I20211119000953IPhysical 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
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes63755$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes60653$0
97530Therapy procedure using functional activities48244$0
97140Therapy procedure using manual technique, each 15 minutes19028$0
97162Evaluation for physical therapy, typically 30 minutes2727$0
View full utilization report →

Insurance plans in this area (ZIP 83686)

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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: 0244267029View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeID
-FL
-ID
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeOR
-ID
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeID

Reviews

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Frequently asked questions

How do I look up DR. TREY BRAEDON LANE (DPT) by NPI?
Use NPI 1487319612 when you need to reference DR. TREY BRAEDON LANE (DPT) in forms, claims, or directories.
Is DR. TREY BRAEDON LANE (DPT)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize DR. TREY BRAEDON LANE (DPT)'s specialty in plain language?
Clinically, the directory lists DR. TREY BRAEDON LANE (DPT) with Physical Therapist. Clinical services aligned with this taxonomy classification.
Does DR. TREY BRAEDON LANE (DPT) practice in Idaho?
You will see Nampa, Idaho on file for DR. TREY BRAEDON LANE (DPT) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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