KEAGAN TICE (PT) – Physical Therapist, NPI 1083265334

KEAGAN TICE (PT) is a healthcare provider. based in University place, Washington. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. PT61001367 (WA). The NPI Number for KEAGAN TICE (PT) is 1083265334

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
KEAGAN TICE (PT)
NPI
1083265334
Phone
(253) 460-1362
Address
7727 40TH ST W STE A
Enumeration Date
26 September 2019
Last Update Date
26 September 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2067888807
Graduation Year
2019 (7 years ago)
PAC ID
7214360254
Group Practice PAC ID
2163781634
Professional Enrollment ID
I20191205002657
Address ID
WA981335315SH17012NXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:6State licenses:1Digital endpointsOther names

3,527 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WA

Provider Addresses for KEAGAN TICE (PT)

  • 7727 40TH ST W STE A

    UNIVERSITY PLACE, WA 984663146

    Phone: (253) 460-1362

    Type: Location

  • Tacoma Mall Boulevard, Tacoma, Pierce County, Washington, 98408-1202, United States

    TACOMA, WA 984096828

    Phone: (253) 581-5200

    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: 2019-12-05

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
I20191205002657IPhysical Therapist In Private PracticeWATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities31642$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes18138$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes8524$0
97140Therapy procedure using manual technique, each 15 minutes8325$0
97161Evaluation for physical therapy, typically 20 minutes1716$0
View full utilization report →

Insurance plans in this area (ZIP 98466)

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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: 2163781634View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeAL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA
-WA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA
-WA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeIL

Reviews

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Frequently asked questions

What unique ID ties claims to KEAGAN TICE (PT)?
NPI 1083265334 is assigned to KEAGAN TICE (PT) under the national enumeration system.
Is KEAGAN TICE (PT) active in the national directory?
KEAGAN TICE (PT)'s public NPI profile is in an active state.
What does KEAGAN TICE (PT) treat or focus on?
Patients typically see KEAGAN TICE (PT) under the specialty Physical Therapist. Clinical services aligned with this taxonomy classification.
What location shows for KEAGAN TICE (PT)?
We surface University Place, Washington for KEAGAN TICE (PT) based on available NPPES addresses.
What if University Place, Washington seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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