MR. NATHANIEL DAVID WITTENBACH (DPT) – Physical Therapist, NPI 1487004743

MR. NATHANIEL DAVID WITTENBACH (DPT) is a healthcare provider. based in Traverse city, Michigan. specializing in Physical Therapist. They hold the professional credentials DPT. They hold a License No. 16613-24 (WI). The NPI Number for MR. NATHANIEL DAVID WITTENBACH (DPT) is 1487004743

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
MR. NATHANIEL DAVID WITTENBACH (DPT)
NPI
1487004743
Phone
(231) 421-9277
Address
3899 W FRONT ST
Enumeration Date
17 June 2016
Last Update Date
19 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2319446541
Graduation Year
2016 (10 years ago)
PAC ID
7012200413
Group Practice PAC ID
6608026190
Professional Enrollment ID
I20160722000560
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness75
Years active:9State licenses:2Digital endpointsOther names

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Provider Addresses for MR. NATHANIEL DAVID WITTENBACH (DPT)

  • 3899, West Front Street, Traverse City, Garfield Township, Grand Traverse County, Michigan, 49684, United States

    UNIT 3

    TRAVERSE CITY, MI 496848103

    Phone: (231) 421-9277

    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: 2016-07-22

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
I20160722000560IPhysical 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 49684)

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Provider's Procedures

MR. NATHANIEL DAVID WITTENBACH (DPT) performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYMI97001Physical therapy evaluation2121

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: 6608026190View full group profile
NameSpecialtyState
-MI
Physical Therapist In Private PracticePA
-IL
-MI
Physical Therapist In Private PracticeFL
-IL
Physical Therapist In Private PracticeMI
-FL
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI

Reviews

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Frequently asked questions

What federal number belongs to MR. NATHANIEL DAVID WITTENBACH (DPT)?
The federal identifier for MR. NATHANIEL DAVID WITTENBACH (DPT) is NPI 1487004743.
Is MR. NATHANIEL DAVID WITTENBACH (DPT)'s NPI currently valid?
The extract we use shows MR. NATHANIEL DAVID WITTENBACH (DPT) as active.
What does MR. NATHANIEL DAVID WITTENBACH (DPT) treat or focus on?
Patients typically see MR. NATHANIEL DAVID WITTENBACH (DPT) under the specialty Physical Therapist. Clinical services aligned with this taxonomy classification.
Where does public data place MR. NATHANIEL DAVID WITTENBACH (DPT)?
The snapshot lists Traverse City, Michigan for MR. NATHANIEL DAVID WITTENBACH (DPT); download NPPES for the complete set.
What if Traverse City, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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