DYNAMIC SPINE & SPORT REHABILITATION LLC – Physical Rehabilitation Occupational Therapist, NPI 1386871630
Physical Rehabilitation Occupational Therapist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DYNAMIC SPINE & SPORT REHABILITATION LLC
8951 W SAHARA AVE STE 190
LAS VEGAS, NV 891175899
Phone: (702) 685-1607
Fax: (702) 685-1506
Type: Mailing
801 S RANCHO DR STE F4
LAS VEGAS, NV 891063814
Phone: (702) 685-1607
Fax: (702) 685-1506
Type: Mailing
2230 N RAINBOW BLVD
LAS VEGAS, NV 891087053
Phone: (702) 808-4943
Fax: (702) 968-8637
Type: Location
8951 W SAHARA AVE
SUITE 190
LAS VEGAS, NV 891175898
Phone: (702) 808-4943
Fax: (702) 968-8637
Type: Mailing
5495 S Rainbow Blvd Ste 102
Las Vegas, NV 891181872
Phone: (585) 305-9810
Type: Location
105 N Pecos Rd Ste 130
Henderson, NV 890741995
Phone: (702) 808-4943
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: 2010-03-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-09-30 (250 days ago).
Enrollment records
1
Earliest due date
2025-09-30
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 |
|---|---|---|---|---|
| O20100302000793 | O | Physical/Occupational Therapy Group In Private Practice | NV | 2025-09-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 89117)
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