MR. TRAVIS WAYNE VANDER REYDEN (P.T.) – Physical Therapist, NPI 1134104292
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,866 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IN
Provider Addresses for MR. TRAVIS WAYNE VANDER REYDEN (P.T.)
53880 Carmichael Dr
South Bend, IN 466351567
Phone: (574) 247-9441
Type: Location
5230 Beck Dr Ste 7
Elkhart, IN 465169059
Phone: (574) 247-9441
Type: Location
North Michigan Street, South Bend, Saint Joseph County, Indiana, 46617, United States
STE. 200
SOUTH BEND, IN 466011244
Phone: (574) 647-1845
Fax: (574) 647-1825
Type: Mailing
Beacon Medical Group, 900, I Street, La Porte, LaPorte County, Indiana, 46350, United States
LAPORTE, IN 463505533
Phone: (219) 324-1700
Type: Location
3600 W BETHEL AVE
MUNCIE, IN 473045407
Phone:
Type: Mailing
60160 BODNAR BLVD
MISHAWAKA, IN 465449338
Phone: (574) 247-9441
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: 2008-03-05
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080305000345 | I | Physical Therapist In Private Practice | IN | 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 | 766 | 72 | $0 |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 241 | 52 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 235 | 43 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 65 | 23 | $0 |
| 97163 | Evaluation for physical therapy, typically 45 minutes | 26 | 26 | $0 |
Insurance plans in this area (ZIP 46635)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | IL | |
| - | IN | |
| Physical Therapist In Private Practice | IL | |
| Physical Therapist In Private Practice | IL | |
| - | IL | |
| Physical Therapist In Private Practice | IL | |
| - | ID | |
| Physical Therapist In Private Practice | IL | |
| - | IN | |
| Physical Therapist In Private Practice | IL |
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