SIERRA JAMISON GAUDREAU (DPT) – Physical Therapist, NPI 1023832086

SIERRA JAMISON GAUDREAU (DPT) is a healthcare provider. based in Grand rapids, Michigan. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 5501303628 (MI). The NPI Number for SIERRA JAMISON GAUDREAU (DPT) is 1023832086

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
SIERRA JAMISON GAUDREAU (DPT)
NPI
1023832086
Phone
(616) 483-3480
Address
625 KENMOOR AVE SE STE 100
Enumeration Date
14 November 2024
Last Update Date
27 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2692342942
Graduation Year
2024 (2 years ago)
PAC ID
0345775425
Group Practice PAC ID
8921065707
Professional Enrollment ID
I20241126002898
Address ID
MI490012725KA1707XSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

3,459 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MI

Provider Addresses for SIERRA JAMISON GAUDREAU (DPT)

  • 625 KENMOOR AVE SE STE 100

    GRAND RAPIDS, MI 495462395

    Phone: (616) 483-3480

    Fax: (616) 356-5001

    Type: Mailing

  • 1707 S PARK ST STE 100

    KALAMAZOO, MI 490012725

    Phone: (269) 234-2942

    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: 2024-11-26

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
I20241126002898IPhysical Therapist In Private PracticeMITBD

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 49546)

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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: 8921065707View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeOR
-MI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI

Reviews

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Frequently asked questions

Is SIERRA JAMISON GAUDREAU (DPT) listed with a National Provider Identifier?
Yes — SIERRA JAMISON GAUDREAU (DPT) has NPI 1023832086 on file in the registry.
Is SIERRA JAMISON GAUDREAU (DPT) still an active registrant?
SIERRA JAMISON GAUDREAU (DPT) carries an active NPI according to the public dataset.
What area of care is associated with SIERRA JAMISON GAUDREAU (DPT)?
SIERRA JAMISON GAUDREAU (DPT)'s record emphasizes Physical Therapist. Clinical services aligned with this taxonomy classification.
Is SIERRA JAMISON GAUDREAU (DPT) located near Grand Rapids?
SIERRA JAMISON GAUDREAU (DPT) currently maps to Grand Rapids, Michigan in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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