BLAKE PETERSON (PT, DPT) – Physical Therapist, NPI 1033780366

BLAKE PETERSON (PT, DPT) is a healthcare provider. based in Raymore, Missouri. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 11-06836 (KS). The NPI Number for BLAKE PETERSON (PT, DPT) is 1033780366

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
BLAKE PETERSON (PT, DPT)
NPI
1033780366
Phone
(816) 318-8109
Address
820 W FOXWOOD DR
Enumeration Date
7 July 2021
Last Update Date
7 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3102730877
Graduation Year
2021 (5 years ago)
PAC ID
3971997206
Group Practice PAC ID
7810071958
Professional Enrollment ID
I20260212002738
Address ID
CA913162834EN5359XBLVD301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:4State licenses:2Digital endpointsOther names

1,541 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MO

Provider Addresses for BLAKE PETERSON (PT, DPT)

  • 820 W FOXWOOD DR

    RAYMORE, MO 640839195

    Phone: (816) 318-8109

    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: 2026-02-12

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

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
I20220302000178IPhysical Therapist In Private PracticeMOTBD
I20230517003416IPhysical Therapist In Private PracticeAZTBD
I20260212002738IPhysical Therapist In Private PracticeCATBD

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 activities19441$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes15341$0
97140Therapy procedure using manual technique, each 15 minutes2715$0
97161Evaluation for physical therapy, typically 20 minutes1818$0
View full utilization report →

Insurance plans in this area (ZIP 64083)

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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: 7810071958View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeNY
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
-CA
Physical Therapist In Private PracticeNJ
-CA

Reviews

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Frequently asked questions

How do payers reference BLAKE PETERSON (PT, DPT)?
For BLAKE PETERSON (PT, DPT), use NPI 1033780366 as the unique 10-digit identifier.
Active or inactive — what applies to BLAKE PETERSON (PT, DPT)?
You should see BLAKE PETERSON (PT, DPT) as active in CMS-hosted NPPES data.
What kind of doctor is BLAKE PETERSON (PT, DPT)?
BLAKE PETERSON (PT, DPT) is associated with Physical Therapist in the directory — Clinical services aligned with this taxonomy classification.
Is BLAKE PETERSON (PT, DPT) associated with Raymore?
Public fields place BLAKE PETERSON (PT, DPT) around Raymore, Missouri. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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