RUSSELL KEVIN BOULDIN (R.P.T) – Physical Therapist, NPI 1770551426
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
888 PHYSICAL THERAPIST IN PRIVATE PRACTICE in NV
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Provider Addresses for RUSSELL KEVIN BOULDIN (R.P.T)
Surgical Arts Center, 9499, West Charleston Boulevard, Las Vegas, Clark County, Nevada, 89117, United States
SUITE 220
LAS VEGAS, NV 891177147
Phone: (702) 933-9394
Fax: (702) 933-9395
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: 2006-01-04
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060104000348 | I | Physical Therapist In Private Practice | NV | 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 |
|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 6,013 | 223 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 1,965 | 194 | $0 |
| 97161 | Evaluation for physical therapy, typically 20 minutes | 204 | 195 | $0 |
Insurance plans in this area (ZIP 89117)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICAL THERAPY | NV | 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 5044 | 232 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | NV | |
| - | NV | |
| Orthopedic Surgery | NV | |
| Physical Therapist In Private Practice | IL |
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