SOUTHEASTERN PHYSICAL THERAPY – Physical Therapist, NPI 1982657433
Physical Therapist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for SOUTHEASTERN PHYSICAL THERAPY
PO BOX 412307
BOSTON, MA 022412307
Phone: (914) 294-4050
Type: Mailing
1311 MAMARONECK AVE STE 140
WHITE PLAINS, NY 106055224
Phone: (914) 294-4050
Type: Mailing
5301, Providence Road, Haven Heights, Virginia Beach, Virginia, 23464, United States
SUITE 80
VIRGINIA BEACH, VA 234644128
Phone: (757) 467-4604
Fax: (757) 467-2716
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: 2024-02-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20160826000390 | O | Independently-Practicing Physical Therapist | VA | TBD |
| O20240202000799 | O | Physical/Occupational Therapy Group In Private Practice | VA | TBD |
| O20240212002520 | O | Clinic/Group Practice | DC | TBD |
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.
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 02241)
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