QUINTIN WYNNE (PT, DPT) – Physical Therapist, NPI 1396421558

QUINTIN WYNNE (PT, DPT) is a healthcare provider. based in Saint louis, Missouri. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 1378054 (TX). The NPI Number for QUINTIN WYNNE (PT, DPT) is 1396421558

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
QUINTIN WYNNE (PT, DPT)
NPI
1396421558
Phone
(314) 445-9890
Address
12531 WOODSTREAM DR
Enumeration Date
23 June 2023
Last Update Date
4 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9723479460
Graduation Year
2023 (3 years ago)
PAC ID
2567824154
Group Practice PAC ID
3274998224
Professional Enrollment ID
I20230814003006
Address ID
TX762272703AU26744DRXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:2State licenses:2Digital endpointsOther names

5,355 PHYSICAL THERAPIST IN PRIVATE PRACTICE in TX

Provider Addresses for QUINTIN WYNNE (PT, DPT)

  • 12531 WOODSTREAM DR

    SAINT LOUIS, MO 631381445

    Phone: (314) 445-9890

    Type: Mailing

  • 26744 E UNIVERSITY DR STE 500

    AUBREY, TX 762272703

    Phone: (972) 347-9460

    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: 2023-08-14

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
I20230814003006IPhysical Therapist In Private PracticeTXTBD

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 63138)

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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: 3274998224View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeNC
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeLA
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX

Reviews

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Frequently asked questions

What is the registry number for QUINTIN WYNNE (PT, DPT)?
The registry entry for QUINTIN WYNNE (PT, DPT) shows NPI 1396421558.
Does the public listing show QUINTIN WYNNE (PT, DPT) as active?
QUINTIN WYNNE (PT, DPT)'s NPI record reflects an active status in NPPES.
What services align with QUINTIN WYNNE (PT, DPT)'s listing?
QUINTIN WYNNE (PT, DPT)'s public classification highlights Physical Therapist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to QUINTIN WYNNE (PT, DPT)?
QUINTIN WYNNE (PT, DPT) is associated with Saint Louis, Missouri in the same public data insurers reference.
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.