NICHOLAS WEBER (MPT) – Physical Therapist, NPI 1063466019

NICHOLAS WEBER (MPT) is a healthcare provider. based in Grand rapids, Michigan. specializing in Physical Therapist. They hold the professional credentials MPT. They hold a License No. 2005017285 (MO). The NPI Number for NICHOLAS WEBER (MPT) is 1063466019

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
NICHOLAS WEBER (MPT)
NPI
1063466019
Phone
(616) 356-5000
Address
607 DEWEY AVE NW
Enumeration Date
22 May 2006
Last Update Date
12 May 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6369284199
Graduation Year
2005 (21 years ago)
PAC ID
7214966332
Group Practice PAC ID
2365342318
Professional Enrollment ID
I20050809000941
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for NICHOLAS WEBER (MPT)

  • 607, Dewey Avenue Northwest, Grand Rapids, Kent County, Michigan, 49504, United States

    STE 300

    GRAND RAPIDS, MI 495047335

    Phone: (616) 356-5000

    Fax: (616) 356-5001

    Type: Mailing

  • 4800, Mexico Road, Saint Peters, Saint Charles County, Missouri, 63376, United States

    SUITE 104

    SAINT PETERS, MO 633761666

    Phone: (636) 939-9540

    Fax: (636) 939-9886

    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: 2005-08-09

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
I20050809000941IPhysical 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities73249$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes64142$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes61137$0
97140Therapy procedure using manual technique, each 15 minutes28824$0
97162Evaluation for physical therapy, typically 30 minutes4531$0
View full utilization report →

Insurance plans in this area (ZIP 49504)

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Provider's Procedures

NICHOLAS WEBER (MPT) performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYMO97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes28838

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: 2365342318View full group profile
NameSpecialtyState
-MO
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
-MI
Physical Therapist In Private PracticeMO
Physical Therapist In Private PracticeMO
-MI
Physical Therapist In Private PracticeMI
-MO

Reviews

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Frequently asked questions

What is the standard ID for NICHOLAS WEBER (MPT) in the U.S.?
In the U.S., NICHOLAS WEBER (MPT) is identified by NPI 1063466019.
Is NICHOLAS WEBER (MPT)'s NPI status active today?
Active status means NICHOLAS WEBER (MPT)'s NPI record is not deactivated in the public file.
How should patients interpret NICHOLAS WEBER (MPT)'s specialty?
The extract shows Physical Therapist for NICHOLAS WEBER (MPT). Clinical services aligned with this taxonomy classification.
What geographic area is tied to NICHOLAS WEBER (MPT)?
NICHOLAS WEBER (MPT) is associated with Grand Rapids, Michigan in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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