MIMI KRISTINA MARINA RIDER (DPT) – Physical Therapist, NPI 1174337687

MIMI KRISTINA MARINA RIDER (DPT) is a healthcare provider. based in Plano, Texas. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 1405007 (TX). The NPI Number for MIMI KRISTINA MARINA RIDER (DPT) is 1174337687

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
MIMI KRISTINA MARINA RIDER (DPT)
NPI
1174337687
Phone
(214) 432-5862
Address
8608 PRESTON RD STE 110
Enumeration Date
4 February 2025
Last Update Date
12 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2144325862
Graduation Year
2024 (2 years ago)
PAC ID
6305367863
Group Practice PAC ID
1850200551
Professional Enrollment ID
I20250313000051
Address ID
TX750243317PL8608XRDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

5,353 PHYSICAL THERAPIST IN PRIVATE PRACTICE in TX

Provider Addresses for MIMI KRISTINA MARINA RIDER (DPT)

  • 8608 PRESTON RD STE 110

    PLANO, TX 750243317

    Phone: (214) 432-5862

    Fax: (214) 431-4305

    Type: Location

  • PO BOX 2650

    COPPELL, TX 750198607

    Phone: (972) 724-2400

    Fax: (972) 724-2495

    Type: Mailing

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: 2025-03-13

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
I20250313000051IPhysical 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 75024)

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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: 1850200551View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
-TX
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 standard ID for MIMI KRISTINA MARINA RIDER (DPT) in the U.S.?
In the U.S., MIMI KRISTINA MARINA RIDER (DPT) is identified by NPI 1174337687.
Does the public listing show MIMI KRISTINA MARINA RIDER (DPT) as active?
MIMI KRISTINA MARINA RIDER (DPT)'s NPI record reflects an active status in NPPES.
Which specialty label fits MIMI KRISTINA MARINA RIDER (DPT)?
NPPES ties MIMI KRISTINA MARINA RIDER (DPT) to Physical Therapist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to MIMI KRISTINA MARINA RIDER (DPT)?
MIMI KRISTINA MARINA RIDER (DPT) shows a connection to Plano, Texas in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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