ALEXANDER WILSON (PT, DPT) – Physical Therapist, NPI 1124904859

ALEXANDER WILSON (PT, DPT) is a healthcare provider. based in Tyler, Texas. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 1407082 (TX). The NPI Number for ALEXANDER WILSON (PT, DPT) is 1124904859

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
ALEXANDER WILSON (PT, DPT)
NPI
1124904859
Phone
(903) 274-9977
Address
1731 MCDONALD RD
Enumeration Date
15 August 2025
Last Update Date
15 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9034054899
Graduation Year
2025 (1 year ago)
PAC ID
1557868023
Group Practice PAC ID
5698144954
Professional Enrollment ID
I20251009002942
Address ID
TX757036231TY5759XBLVD401
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

5,353 PHYSICAL THERAPIST IN PRIVATE PRACTICE in TX

Provider Addresses for ALEXANDER WILSON (PT, DPT)

  • 1731 MCDONALD RD

    TYLER, TX 757014724

    Phone: (903) 274-9977

    Fax: (903) 638-2741

    Type: Mailing

  • 5759 EAGLES NEST BLVD STE 4

    TYLER, TX 757036231

    Phone: (903) 405-4899

    Fax: (903) 638-2741

    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: 2025-10-09

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
I20251009002942IPhysical 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 75701)

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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: 5698144954View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeTX

Reviews

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Frequently asked questions

How is ALEXANDER WILSON (PT, DPT) identified in CMS data?
CMS-hosted NPPES data lists ALEXANDER WILSON (PT, DPT) with NPI 1124904859.
Does the file indicate ALEXANDER WILSON (PT, DPT) is practicing under active NPI?
Directory data currently reports ALEXANDER WILSON (PT, DPT) as active.
What is ALEXANDER WILSON (PT, DPT)'s primary classification?
Physical Therapist is the headline specialty for ALEXANDER WILSON (PT, DPT) here. Clinical services aligned with this taxonomy classification.
What area does ALEXANDER WILSON (PT, DPT) serve?
ALEXANDER WILSON (PT, DPT)'s listing highlights Tyler, Texas; more addresses can appear in NPPES.
Why does ALEXANDER WILSON (PT, DPT) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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