EMILIE L PETERSON (DPT) – Physical Therapist, NPI 1588065882

EMILIE L PETERSON (DPT) is a healthcare provider. based in Pocatello, Idaho. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. PT-3602 (ID). The NPI Number for EMILIE L PETERSON (DPT) is 1588065882

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
EMILIE L PETERSON (DPT)
NPI
1588065882
Phone
(208) 233-2248
Address
1800 FLANDRO DR STE 190
Enumeration Date
6 September 2014
Last Update Date
6 September 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2085527700837
Graduation Year
2014 (12 years ago)
PAC ID
0749408615
Group Practice PAC ID
1052480076
Professional Enrollment ID
I20140908000164
Address ID
ID834044979ID3820XLNXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

834 PHYSICAL THERAPIST IN PRIVATE PRACTICE in ID

Provider Addresses for EMILIE L PETERSON (DPT)

  • 1800 FLANDRO DR STE 190

    POCATELLO, ID 832024940

    Phone: (208) 233-2248

    Type: Location

  • 2001 BIRDIE THOMPSON DR APT 801

    POCATELLO, ID 832012774

    Phone: (208) 570-3636

    Type: Mailing

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: 2014-09-08

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
I20140908000164IPhysical 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
97140Therapy procedure using manual technique, each 15 minutes90142$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes55138$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care33132$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes3711$0
97162Evaluation for physical therapy, typically 30 minutes1717$0
View full utilization report →

Insurance plans in this area (ZIP 83202)

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Provider's Procedures

EMILIE L PETERSON (DPT) 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 THERAPYID97001Physical therapy evaluation6060
PHYSICAL THERAPYID97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes161583
PHYSICAL THERAPYID97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes44774

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: 1052480076View full group profile
NameSpecialtyState
Physician AssistantID
-ID
Physical Therapist In Private PracticeID
-ID
Physician AssistantID
Physician AssistantID
-ID
Physical Therapist In Private PracticeWA
Family PracticeID
Physician AssistantID

Reviews

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Frequently asked questions

Where can patients find EMILIE L PETERSON (DPT)'s NPI?
You can confirm EMILIE L PETERSON (DPT) with NPI 1588065882; it appears in the national provider directory.
Does this profile mean EMILIE L PETERSON (DPT) is currently active?
Yes — EMILIE L PETERSON (DPT) appears active in the national provider directory.
Does EMILIE L PETERSON (DPT) list a primary specialty?
If you are matching referrals, note Physical Therapist for EMILIE L PETERSON (DPT). Clinical services aligned with this taxonomy classification.
Where is EMILIE L PETERSON (DPT)'s primary listing?
We display Pocatello, Idaho because that is what the record indicates for EMILIE L PETERSON (DPT).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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