BLAKE TIEDTKE (DPT) – Physical Medicine & Rehabilitation Physician, NPI 1922248566
Physical Medicine & Rehabilitation Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,303 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IA
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Provider Addresses for BLAKE TIEDTKE (DPT)
3290, Ridgeway Drive, Coralville, Johnson County, Iowa, 52317, United States
STE 3
CORALVILLE, IA 52241
Phone: (319) 665-2630
Fax: (319) 665-2631
Type: Mailing
645, 32nd Avenue Southwest, Cedar Rapids, Linn County, Iowa, 52404, United States
STE A
CEDAR RAPIDS, IA 524043907
Phone: (319) 363-2901
Fax: (319) 363-2903
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: 2009-04-03
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 |
|---|---|---|---|---|
| I20090403000411 | I | Physical Therapist In Private Practice | IA | 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 |
|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 464 | 29 | $0 |
| 97530 | Therapy procedure using functional activities | 463 | 27 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 441 | 26 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 348 | 26 | $0 |
| 97161 | Evaluation for physical therapy, typically 20 minutes | 23 | 21 | $0 |
Insurance plans in this area (ZIP 52241)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | IA | |
| Physical Therapist In Private Practice | IA | |
| Physical Therapist In Private Practice | IA | |
| - | IA | |
| Physical Therapist In Private Practice | IA | |
| Physical Therapist In Private Practice | IA | |
| Physical Therapist In Private Practice | IA | |
| Physical Therapist In Private Practice | IA | |
| Physical Therapist In Private Practice | IA | |
| Physical Therapist In Private Practice | IA |
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