JACOB JAN LEE (DPT) – Physical Therapist, NPI 1811513781

JACOB JAN LEE (DPT) is a healthcare provider. based in Douglas, Wyoming. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 1963 (WY). The NPI Number for JACOB JAN LEE (DPT) is 1811513781

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
JACOB JAN LEE (DPT)
NPI
1811513781
Phone
(307) 358-9464
Address
PO BOX 1790
Enumeration Date
17 June 2020
Last Update Date
28 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3603773395
Graduation Year
2020 (6 years ago)
PAC ID
1951724129
Group Practice PAC ID
7416010574
Professional Enrollment ID
I20250302000029
Address ID
WA983102701BR900XXRDXX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

3,527 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WA

Provider Addresses for JACOB JAN LEE (DPT)

  • PO BOX 1790

    DOUGLAS, WY 826331790

    Phone: (307) 358-9464

    Fax: (307) 358-9330

    Type: Mailing

  • 900 SHERIDAN RD

    BREMERTON, WA 983102701

    Phone: (360) 377-3395

    Type: Location

  • 953 WALNUT ST

    WHEATLAND, WY 822012665

    Phone: (307) 322-1878

    Fax: (307) 322-1879

    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: 2025-03-02

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
I20250302000029IPhysical 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 82633)

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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: 7416010574View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeWA

Reviews

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Frequently asked questions

Can I cross-check JACOB JAN LEE (DPT) using NPI 1811513781?
NPI 1811513781 belongs to JACOB JAN LEE (DPT); compare other details if you need extra assurance.
Active or inactive — what applies to JACOB JAN LEE (DPT)?
You should see JACOB JAN LEE (DPT) as active in CMS-hosted NPPES data.
What expertise is attributed to JACOB JAN LEE (DPT)?
JACOB JAN LEE (DPT)'s specialty line reads Physical Therapist. Clinical services aligned with this taxonomy classification.
Is JACOB JAN LEE (DPT) associated with Douglas?
Public fields place JACOB JAN LEE (DPT) around Douglas, Wyoming. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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