KIM ALAN ANDERSON (PT) – Physical Therapist, NPI 1225174683

KIM ALAN ANDERSON (PT) is a healthcare provider. based in Minneapolis, Minnesota. specializing in Physical Therapist. They hold the professional credentials PT. They hold a License No. 2787 (MN). The NPI Number for KIM ALAN ANDERSON (PT) is 1225174683

Main info

Male
42 Years Of Experience
Accepts Medicare Assignment
Name
KIM ALAN ANDERSON (PT)
NPI
1225174683
Phone
(612) 707-0169
Address
2801 WAYZATA BLVD
Enumeration Date
30 January 2007
Last Update Date
19 March 2020

Doctor Profile

Medical School Name
UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE
Secondary Phone
6127070169
Graduation Year
1984 (42 years ago)
PAC ID
4486691748
Group Practice PAC ID
0143643833
Professional Enrollment ID
I20050408000685
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for KIM ALAN ANDERSON (PT)

  • Wayzata Blvd, South Wayzata Boulevard, Minneapolis, Hennepin County, Minnesota, 55416, United States

    MINNEAPOLIS, MN 554052125

    Phone: (612) 707-0169

    Fax: (612) 465-1603

    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: 2005-04-08

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
I20050408000685IPhysical 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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities88345$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes51533$0
97140Therapy procedure using manual technique, each 15 minutes48342$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes9012$0
97535Training for self-care or home management, each 15 minutes7242$0
View full utilization report →

Insurance plans in this area (ZIP 55405)

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Provider's Procedures

KIM ALAN ANDERSON (PT) performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYMN97001Physical therapy evaluation4140

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: 0143643833View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMN
-MN
Physical Therapist In Private PracticeOR

Reviews

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Frequently asked questions

How do I look up KIM ALAN ANDERSON (PT) by NPI?
Use NPI 1225174683 when you need to reference KIM ALAN ANDERSON (PT) in forms, claims, or directories.
Is KIM ALAN ANDERSON (PT)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize KIM ALAN ANDERSON (PT)'s specialty in plain language?
Clinically, the directory lists KIM ALAN ANDERSON (PT) with Physical Therapist. Clinical services aligned with this taxonomy classification.
Does KIM ALAN ANDERSON (PT) practice in Minnesota?
You will see Minneapolis, Minnesota on file for KIM ALAN ANDERSON (PT) alongside any extra practice locations.
What if Minneapolis, Minnesota seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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