BRAID RENEE WEICK (PT) – Physical Therapist, NPI 1639919004

BRAID RENEE WEICK (PT) is a healthcare provider. based in Star, Idaho. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. PT9020 (ID). The NPI Number for BRAID RENEE WEICK (PT) is 1639919004

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
BRAID RENEE WEICK (PT)
NPI
1639919004
Phone
Not provided
Address
11877 W BLAKE DR
Enumeration Date
31 May 2024
Last Update Date
31 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2088888306
Graduation Year
2024 (2 years ago)
PAC ID
1951846575
Group Practice PAC ID
4789078312
Professional Enrollment ID
I20240708003276
Address ID
ID836463171ME4842XWAYX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

834 PHYSICAL THERAPIST IN PRIVATE PRACTICE in ID

Provider Addresses for BRAID RENEE WEICK (PT)

  • 11877 W BLAKE DR

    STAR, ID 836695617

    Phone:

    Type: Mailing

  • 4842 N CORTONA WAY STE 100

    MERIDIAN, ID 836463171

    Phone: (208) 888-8306

    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: 2024-07-08

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
I20240708003276IPhysical 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.

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

Insurance plans in this area (ZIP 83669)

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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: 4789078312View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeAZ
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeWA
Occupational Therapist In Private PracticeID
Occupational Therapist In Private PracticeID
Physical Therapist In Private PracticeID
Occupational Therapist In Private PracticeID

Reviews

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Frequently asked questions

How is BRAID RENEE WEICK (PT) identified in CMS data?
CMS-hosted NPPES data lists BRAID RENEE WEICK (PT) with NPI 1639919004.
Is BRAID RENEE WEICK (PT) listed as active for patients and plans?
The listing shows BRAID RENEE WEICK (PT) as active in the NPI system.
What healthcare role does BRAID RENEE WEICK (PT) hold?
Scheduling teams often label BRAID RENEE WEICK (PT) under Physical Therapist. Clinical services aligned with this taxonomy classification.
Where should I expect BRAID RENEE WEICK (PT) on a map?
Expect Star, Idaho as a primary anchor for BRAID RENEE WEICK (PT) unless the record lists multiple sites.
Why does BRAID RENEE WEICK (PT) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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