TANNER ALAN GAGNON – Physical Therapist, NPI 1194394775
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,253 PHYSICAL THERAPIST IN PRIVATE PRACTICE in PA
Provider Addresses for TANNER ALAN GAGNON
790 REMINGTON BLVD
BOLINGBROOK, IL 604404909
Phone:
Type: Mailing
101 W CITY AVE STE B
BALA CYNWYD, PA 190043164
Phone: (484) 270-9170
Type: Location
33900 HARPER AVE STE 104
CLINTON TWP, MI 480354258
Phone:
Type: Mailing
3069 UNIVERSITY DR STE 230
AUBURN HILLS, MI 483262322
Phone: (248) 243-8770
Fax: (248) 243-8771
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: 2024-06-13
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 |
|---|---|---|---|---|
| I20210625000357 | I | Physical Therapist In Private Practice | PA | TBD |
| I20240613004061 | I | Physical Therapist In Private Practice | MI | 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 |
|---|---|---|---|---|
| 97530 | Therapy procedure using functional activities | 401 | 24 | $0 |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 283 | 23 | $0 |
| 97162 | Evaluation for physical therapy, typically 30 minutes | 17 | 13 | $0 |
Insurance plans in this area (ZIP 60440)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Physical Therapist In Private Practice | IL | |
| - | IL | |
| Occupational Therapist In Private Practice | MI | |
| - | MI | |
| - | MI | |
| Physical Therapist In Private Practice | MI | |
| Physical Therapist In Private Practice | IL | |
| Physical Therapist In Private Practice | IL | |
| Physical Therapist In Private Practice | MI |
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