ANDREW NIELSEN (PT, DPT) – Orthopedic Physical Therapist, NPI 1053806703

ANDREW NIELSEN (PT, DPT) is a healthcare provider. based in Gillette, Wyoming. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. The NPI Number for ANDREW NIELSEN (PT, DPT) is 1053806703

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
ANDREW NIELSEN (PT, DPT)
NPI
1053806703
Phone
(308) 530-7625
Address
600 Running W Dr
Enumeration Date
26 June 2018
Last Update Date
18 July 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3076868177
Graduation Year
2016 (10 years ago)
PAC ID
0042561615
Group Practice PAC ID
3072648468
Professional Enrollment ID
I20180920000867
Address ID
WY827185582GI1103XRDXX403
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:7State licenses:0Digital endpointsOther names

389 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WY

Provider Addresses for ANDREW NIELSEN (PT, DPT)

  • 600 Running W Dr

    Gillette, WY 827182017

    Phone: (308) 530-7625

    Type: Location

  • Running W Drive, RC Ranch, Gillette, Campbell County, Wyoming, 82718, United States

    GILLETTE, WY 827182017

    Phone: (308) 530-7625

    Type: Mailing

  • 1103, East Boxelder Road, Gillette, Campbell County, Wyoming, 82718, United States

    GILLETTE, WY 82718

    Phone: (307) 686-8177

    Fax: (307) 686-9484

    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: 2018-09-20

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
I20180920000867IPhysical Therapist In Private PracticeWYTBD

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
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes30947$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes14043$0
97140Therapy procedure using manual technique, each 15 minutes11831$0
97116Therapy procedure for walking training, each 15 minutes6611$0
97161Evaluation for physical therapy, typically 20 minutes1816$0
View full utilization report →

Insurance plans in this area (ZIP 82718)

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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: 3072648468View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeWY
Physical Therapist In Private PracticeWY
Physical Therapist In Private PracticeWY
Physical Therapist In Private PracticeWY
Occupational Therapist In Private PracticeCO
Physical Therapist In Private PracticeWY
Physical Therapist In Private PracticeWY
Physical Therapist In Private PracticeWY
Physical Therapist In Private PracticeWY
Physical Therapist In Private PracticeWY

Reviews

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Frequently asked questions

What is the 10-digit NPI for ANDREW NIELSEN (PT, DPT)?
ANDREW NIELSEN (PT, DPT) — NPI 1053806703 — is the standard way to identify this listing.
Is ANDREW NIELSEN (PT, DPT) listed as active for patients and plans?
The listing shows ANDREW NIELSEN (PT, DPT) as active in the NPI system.
What is ANDREW NIELSEN (PT, DPT)'s primary classification?
Orthopedic Physical Therapist is the headline specialty for ANDREW NIELSEN (PT, DPT) here. Clinical services aligned with this taxonomy classification.
What address line appears for ANDREW NIELSEN (PT, DPT)?
ANDREW NIELSEN (PT, DPT)'s geographic hint is Gillette, Wyoming in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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