NATHAN SCANDRETT (DPT) – Physical Therapist, NPI 1205225075

NATHAN SCANDRETT (DPT) is a healthcare provider. based in Godfrey, Illinois. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. IL 070.020882 (IL). The NPI Number for NATHAN SCANDRETT (DPT) is 1205225075

Main info

Male
Sole Proprietor
12 Years Of Experience
Accepts Medicare Assignment
Name
NATHAN SCANDRETT (DPT)
NPI
1205225075
Phone
Not provided
Address
4813 DADRIAN DR
Enumeration Date
17 January 2015
Last Update Date
17 January 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6364779911
Graduation Year
2014 (12 years ago)
PAC ID
8224371356
Group Practice PAC ID
4789602681
Professional Enrollment ID
I20220531000959
Address ID
MO633762438SA221XXRDXX307
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

5,030 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IL

Provider Addresses for NATHAN SCANDRETT (DPT)

  • 4813 DADRIAN DR

    GODFREY, IL 620351646

    Phone:

    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: 2022-05-31

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
I20220531000959IPhysical Therapist In Private PracticeMOTBD

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 62035)

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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: 4789602681View full group profile
NameSpecialtyState
-IL
Physical Therapist In Private PracticeIL
-IL
-IL
Physical Therapist In Private PracticeVA
-MI
-IL
Physical Therapist In Private PracticeAZ
Physical Therapist In Private PracticeIL
-MI

Reviews

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Frequently asked questions

What NPI should I save for NATHAN SCANDRETT (DPT)?
Save NPI 1205225075 if you need a stable reference for NATHAN SCANDRETT (DPT).
Is NATHAN SCANDRETT (DPT) active in the national directory?
NATHAN SCANDRETT (DPT)'s public NPI profile is in an active state.
Does NATHAN SCANDRETT (DPT) list a primary specialty?
If you are matching referrals, note Physical Therapist for NATHAN SCANDRETT (DPT). Clinical services aligned with this taxonomy classification.
Does NATHAN SCANDRETT (DPT) practice in Illinois?
You will see Godfrey, Illinois on file for NATHAN SCANDRETT (DPT) alongside any extra practice locations.
How can I contact NATHAN SCANDRETT (DPT)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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