ALEXANDER RYAN PETERSON – Physical Therapist, NPI 1023994381

ALEXANDER RYAN PETERSON is a healthcare provider. based in Louisville, Kentucky. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 6483 (OK). The NPI Number for ALEXANDER RYAN PETERSON is 1023994381

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
ALEXANDER RYAN PETERSON
NPI
1023994381
Phone
(726) 202-3039
Address
1650 LYNDON FARM CT STE 300
Enumeration Date
13 August 2025
Last Update Date
13 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4057261580
Graduation Year
2025 (1 year ago)
PAC ID
1355845413
Group Practice PAC ID
2365768231
Professional Enrollment ID
I20250919004402
Address ID
OK730132248ED15101CTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

845 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OK

Provider Addresses for ALEXANDER RYAN PETERSON

  • 1650 LYNDON FARM CT STE 300

    LOUISVILLE, KY 402235005

    Phone: (726) 202-3039

    Type: Mailing

  • 15101 LLEYTONS CT STE 102

    EDMOND, OK 730132248

    Phone: (405) 726-1580

    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: 2025-09-19

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
I20250919004402IPhysical Therapist In Private PracticeOKTBD

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 40223)

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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: 2365768231View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeOK
Physical Therapist In Private PracticeOK
Physical Therapist In Private PracticeOK
-OK
-OK
-OK
Physical Therapist In Private PracticeOK
Physical Therapist In Private PracticeOK
-OK
Physical Therapist In Private PracticeOK

Reviews

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Frequently asked questions

Is ALEXANDER RYAN PETERSON listed with a National Provider Identifier?
Yes — ALEXANDER RYAN PETERSON has NPI 1023994381 on file in the registry.
Is ALEXANDER RYAN PETERSON still an active registrant?
ALEXANDER RYAN PETERSON carries an active NPI according to the public dataset.
What kind of doctor is ALEXANDER RYAN PETERSON?
ALEXANDER RYAN PETERSON is associated with Physical Therapist in the directory — Clinical services aligned with this taxonomy classification.
Where in Kentucky is ALEXANDER RYAN PETERSON registered?
Use Louisville, Kentucky as the headline location for ALEXANDER RYAN PETERSON here.
Does ALEXANDER RYAN PETERSON accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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