MARYSA MEYER (PT, DPT) – Physical Therapist, NPI 1154851053

MARYSA MEYER (PT, DPT) is a healthcare provider. based in Roseville, Minnesota. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 11058 (MN). The NPI Number for MARYSA MEYER (PT, DPT) is 1154851053

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
MARYSA MEYER (PT, DPT)
NPI
1154851053
Phone
(952) 835-4512
Address
1769 LEXINGTON AVE N # 286
Enumeration Date
14 June 2017
Last Update Date
15 August 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7634007828
Graduation Year
2018 (8 years ago)
PAC ID
0749552875
Group Practice PAC ID
2567685647
Professional Enrollment ID
I20180724003628
Address ID
MN553694510MA11280NXXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

2,108 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MN

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Provider Addresses for MARYSA MEYER (PT, DPT)

  • Lexington Avenue North, Lexington Estates, Roseville, Ramsey County, Minnesota, United States

    ROSEVILLE, MN 551136522

    Phone: (952) 835-4512

    Type: Mailing

  • Excelsior Boulevard, Minikahda Vista, Saint Louis Park, Hennepin County, Minnesota, 55416, United States

    ST LOUIS PARK, MN 55416

    Phone: (877) 709-1090

    Fax: (866) 221-3400

    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: 2018-07-24

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
I20180724003628IPhysical Therapist In Private PracticeMNTBD

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 55113)

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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: 2567685647View full group profile
NameSpecialtyState
Clinical PsychologistMN
Nurse PractitionerMN
Clinical Social WorkerMN
Nurse PractitionerMN
-MN
Mental Health CounselorMN
Marriage And Family TherapistMN
Marriage And Family TherapistMN
Clinical PsychologistMN
-MN

Reviews

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Frequently asked questions

What is the 10-digit NPI for MARYSA MEYER (PT, DPT)?
MARYSA MEYER (PT, DPT) — NPI 1154851053 — is the standard way to identify this listing.
Can I rely on MARYSA MEYER (PT, DPT) being an active provider?
As of the registry snapshot, MARYSA MEYER (PT, DPT) is marked active.
What is MARYSA MEYER (PT, DPT) best known for clinically?
Directory data describes MARYSA MEYER (PT, DPT) with Physical Therapist. Clinical services aligned with this taxonomy classification.
Where is MARYSA MEYER (PT, DPT) based?
MARYSA MEYER (PT, DPT) is tied to Roseville, Minnesota in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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