HALEY TANYA PETERSON (DPT) – Physical Therapist, NPI 1972088565
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for HALEY TANYA PETERSON (DPT)
11995 SINGLETREE LN STE 120
EDEN PRAIRIE, MN 553445338
Phone: (952) 373-5720
Fax: (763) 260-7653
Type: Mailing
2460 Garlick Blvd Ste B
Richland, WA 993541786
Phone: (509) 375-1015
Type: Location
3335 Blaisdell Ave
Minneapolis, MN 554084429
Phone: (952) 222-5769
Fax: (763) 260-7653
Type: Location
12301 Ridgedale Dr
Minnetonka, MN 553051738
Phone: (952) 222-5769
Fax: (763) 260-7653
Type: Location
3575 North Berens Rd NW
Prior Lake, MN 553795899
Phone: (952) 222-5769
Fax: (763) 260-7653
Type: Location
7355 York Ave S
Edina, MN 554354701
Phone: (952) 222-5769
Fax: (763) 260-7653
Type: Location
1426 Mendota Rd
Inver Grove Heights, MN 550771256
Phone: (952) 222-5769
Fax: (763) 260-7653
Type: Location
7601 42nd Ave N
New Hope, MN 554271226
Phone: (952) 222-5769
Fax: (763) 260-7653
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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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: 2019-09-27
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190927000546 | I | Physical Therapist In Private Practice | MN | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97140 | Therapy procedure using manual technique, each 15 minutes | 313 | 15 | $0 |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 67 | 13 | $0 |
Insurance plans in this area (ZIP 55344)
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Group practice members
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