TAYLOR M DITTMANN (PT, DPT) – Physical Therapist, NPI 1215475223

TAYLOR M DITTMANN (PT, DPT) is a healthcare provider. based in Desloge, Missouri. specializing in Physical Therapist. They hold the professional credentials PT, DPT. They hold a License No. 2017003393 (MO). The NPI Number for TAYLOR M DITTMANN (PT, DPT) is 1215475223

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
TAYLOR M DITTMANN (PT, DPT)
NPI
1215475223
Phone
(573) 431-0223
Address
801 Brim St
Enumeration Date
9 February 2017
Last Update Date
18 September 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3148942222
Graduation Year
2016 (10 years ago)
PAC ID
8729318126
Group Practice PAC ID
3577885326
Professional Enrollment ID
I20190927001677
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

Provider Addresses for TAYLOR M DITTMANN (PT, DPT)

  • 801 Brim St

    Desloge, MO 636013441

    Phone: (573) 431-0223

    Type: Location

  • 790, Remington Boulevard, Bolingbrook, Will County, Illinois, 60440, United States

    BOLINGBROOK, IL 604404909

    Phone: (314) 894-2222

    Type: Mailing

  • 4418, Telegraph Road, Oakville, Saint Louis County, Missouri, 63129, United States

    OAKVILLE, MO 631293316

    Phone: (314) 894-2222

    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: 2019-09-27

PECOS data refreshed: 2026-06-15

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
I20190927001677IPhysical Therapist In Private PracticeMOTBD

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 63601)

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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: 3577885326View full group profile
NameSpecialtyState
-IL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeMO
-IL

Reviews

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Frequently asked questions

What identifier follows TAYLOR M DITTMANN (PT, DPT) across health systems?
The NPI 1215475223 uniquely identifies TAYLOR M DITTMANN (PT, DPT) in U.S. healthcare data.
Does the public listing show TAYLOR M DITTMANN (PT, DPT) as active?
TAYLOR M DITTMANN (PT, DPT)'s NPI record reflects an active status in NPPES.
What does the directory say TAYLOR M DITTMANN (PT, DPT) does?
Insurance directories may phrase it differently, but here TAYLOR M DITTMANN (PT, DPT) maps to Physical Therapist. Clinical services aligned with this taxonomy classification.
Can patients visit TAYLOR M DITTMANN (PT, DPT) in Desloge, Missouri?
For routing, start with Desloge, Missouri for TAYLOR M DITTMANN (PT, DPT), then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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