KYLE ETHAN SHOPE – Physical Therapist, NPI 1063236966

KYLE ETHAN SHOPE is a healthcare provider. based in Henrico, Virginia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 2305216827 (VA). The NPI Number for KYLE ETHAN SHOPE is 1063236966

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
KYLE ETHAN SHOPE
NPI
1063236966
Phone
Not provided
Address
3001 HUNGARY SPRING RD STE D
Enumeration Date
8 November 2024
Last Update Date
8 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8047568490
Graduation Year
2024 (2 years ago)
PAC ID
7012438690
Group Practice PAC ID
3779588256
Professional Enrollment ID
I20250312000411
Address ID
VA232282428RI3001XRDXX402
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

3,079 PHYSICAL THERAPIST IN PRIVATE PRACTICE in VA

Provider Addresses for KYLE ETHAN SHOPE

  • 3001 HUNGARY SPRING RD STE D

    HENRICO, VA 232282428

    Phone:

    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: 2025-03-12

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
I20250312000411IPhysical Therapist In Private PracticeVATBD

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 23228)

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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: 3779588256View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeVA
-VA
Physical Therapist In Private PracticeVA
-MD
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
-VA
Physical Therapist In Private PracticeVA

Reviews

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Frequently asked questions

Does KYLE ETHAN SHOPE share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KYLE ETHAN SHOPE uses 1063236966.
Does CMS list KYLE ETHAN SHOPE as active?
Yes — KYLE ETHAN SHOPE is active in the NPI listing used on this page.
What healthcare role does KYLE ETHAN SHOPE hold?
Scheduling teams often label KYLE ETHAN SHOPE under Physical Therapist. Clinical services aligned with this taxonomy classification.
What address line appears for KYLE ETHAN SHOPE?
KYLE ETHAN SHOPE's geographic hint is Henrico, Virginia in our summary view.
Why does KYLE ETHAN SHOPE 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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