JUSTIN MICHAEL PETTIT (DPT) – Physical Therapist, NPI 1962397323

JUSTIN MICHAEL PETTIT (DPT) is a healthcare provider. based in Omaha, Nebraska. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 4787 (NE). The NPI Number for JUSTIN MICHAEL PETTIT (DPT) is 1962397323

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
JUSTIN MICHAEL PETTIT (DPT)
NPI
1962397323
Phone
(402) 393-9390
Address
8642 F ST
Enumeration Date
9 June 2025
Last Update Date
9 June 2025

Doctor Profile

Medical School Name
UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Secondary Phone
4025049797
Graduation Year
2025 (1 year ago)
PAC ID
5193236784
Group Practice PAC ID
1254460496
Professional Enrollment ID
I20250619002486
Address ID
NE680225659EL19111PLZX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

841 PHYSICAL THERAPIST IN PRIVATE PRACTICE in NE

Provider Addresses for JUSTIN MICHAEL PETTIT (DPT)

  • 8642 F ST

    OMAHA, NE 681271639

    Phone: (402) 393-9390

    Fax: (402) 393-9388

    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: 2025-06-19

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
I20250619002486IPhysical Therapist In Private PracticeNETBD

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 68127)

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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: 1254460496View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeNE
Occupational Therapist In Private PracticeNE
Physical Therapist In Private PracticeNE
Physical Therapist In Private PracticeNE
Physical Therapist In Private PracticeNE
Physical Therapist In Private PracticeNE
Occupational Therapist In Private PracticeNE
Physical Therapist In Private PracticeNE
Physical Therapist In Private PracticeNE

Reviews

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Frequently asked questions

Is JUSTIN MICHAEL PETTIT (DPT) listed with a National Provider Identifier?
Yes — JUSTIN MICHAEL PETTIT (DPT) has NPI 1962397323 on file in the registry.
Active or inactive — what applies to JUSTIN MICHAEL PETTIT (DPT)?
You should see JUSTIN MICHAEL PETTIT (DPT) as active in CMS-hosted NPPES data.
What kind of doctor is JUSTIN MICHAEL PETTIT (DPT)?
JUSTIN MICHAEL PETTIT (DPT) is associated with Physical Therapist in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for JUSTIN MICHAEL PETTIT (DPT)?
Travel planning: use Omaha, Nebraska as the reference point for JUSTIN MICHAEL PETTIT (DPT), then confirm.
When was this NPI issued?
Enumeration for JUSTIN MICHAEL PETTIT (DPT) is noted as June 9, 2025 where the registry provides it.

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