ROXANNE RENAE KUDWA (MSPT) – Physical Therapist, NPI 1104132877

ROXANNE RENAE KUDWA (MSPT) is a healthcare provider. based in Saint johns, Michigan. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials MSPT. They hold a License No. 5501009453 (MI). The NPI Number for ROXANNE RENAE KUDWA (MSPT) is 1104132877

Main info

Female
28 Years Of Experience
Accepts Medicare Assignment
Name
ROXANNE RENAE KUDWA (MSPT)
NPI
1104132877
Phone
(989) 227-5404
Address
1507 WATERFORD PKWY
Enumeration Date
19 August 2010
Last Update Date
19 August 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5172670200
Graduation Year
1998 (28 years ago)
PAC ID
6204722689
Group Practice PAC ID
8527026442
Professional Enrollment ID
I20040224000053
Address ID
MI489114217LA3404XDRXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

3,459 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MI

Provider Addresses for ROXANNE RENAE KUDWA (MSPT)

  • 1507 WATERFORD PKWY

    SAINT JOHNS, MI 488799630

    Phone: (989) 227-5404

    Fax: (989) 227-5415

    Mailing address matches the actual address.

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: 2004-02-24

PECOS data refreshed: 2026-06-15

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
I20040224000053IPhysical 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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes39536$0
97140Therapy procedure using manual technique, each 15 minutes12421$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes9016$0
97530Therapy procedure using functional activities6413$0
97161Evaluation for physical therapy, typically 20 minutes2320$0
View full utilization report →

Insurance plans in this area (ZIP 48879)

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Provider's Procedures

ROXANNE RENAE KUDWA (MSPT) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYMI97001Physical therapy evaluation2121
PHYSICAL THERAPYMI97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes60843

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: 8527026442View full group profile
NameSpecialtyState
Orthopedic SurgeryMI
Physical Therapist In Private PracticeMI
Orthopedic SurgeryMI
Physician AssistantMI
Orthopedic SurgeryMI
Orthopedic SurgeryMI
Orthopedic SurgeryMI
Physical Therapist In Private PracticeMI
Physician AssistantMI
Orthopedic Surgery, Sports MedicineMI

Reviews

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Frequently asked questions

What is the registry number for ROXANNE RENAE KUDWA (MSPT)?
The registry entry for ROXANNE RENAE KUDWA (MSPT) shows NPI 1104132877.
Is ROXANNE RENAE KUDWA (MSPT)'s NPI status active today?
Active status means ROXANNE RENAE KUDWA (MSPT)'s NPI record is not deactivated in the public file.
What services align with ROXANNE RENAE KUDWA (MSPT)'s listing?
ROXANNE RENAE KUDWA (MSPT)'s public classification highlights Physical Therapist. Clinical services aligned with this taxonomy classification.
What city is tied to ROXANNE RENAE KUDWA (MSPT)?
The directory associates ROXANNE RENAE KUDWA (MSPT) with Saint Johns, Michigan. Check all listed addresses for suites or satellite offices.
Who maintains ROXANNE RENAE KUDWA (MSPT)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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