Proactive Physical Therapy Pc - Medicare Physical Therapist in Burley, ID

Proactive Physical Therapy Pc is a medicare enrolled "Physical Therapist" provider in Burley, Idaho. Their current practice location is 2311 Park Ave, Suite 2, Burley, Idaho. You can reach out to their office (for appointments etc.) via phone at (208) 677-2489.

Proactive Physical Therapy Pc is licensed to practice in Idaho (license number PT1299) and it also participates in the medicare program. Proactive Physical Therapy Pc is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1609093434.

Contact Information

Proactive Physical Therapy Pc
2311 Park Ave, Suite 2,
Burley, ID 83318-2170
(208) 677-2489
(208) 677-4023



Healthcare Provider's Profile

Full NameProactive Physical Therapy Pc
TypeFacility
SpecialityPhysical Therapist
Location2311 Park Ave, Burley, Idaho
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1609093434
  • Provider Enumeration Date: 04/20/2007
  • Last Update Date: 10/13/2010
  Medicare PECOS Information:
  • PECOS PAC ID: 8820277593
  • Enrollment ID: O20110126001167

Medical Identifiers

Medical identifiers for Proactive Physical Therapy Pc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1609093434NPI-NPPES
805407300MedicaidID

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225100000XPhysical Therapist PT1299 (Idaho)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Proactive Physical Therapy Pc acts as a billing entity for following providers:
Provider NameRaulan Young
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1700954161
PECOS PAC ID: 0547449217
Enrollment ID: I20110126001180

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Proactive Physical Therapy Pc is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Proactive Physical Therapy Pc
2311 Park Ave, Suite 2,
Burley, ID 83318-2170

Ph: (208) 677-2489
Proactive Physical Therapy Pc
2311 Park Ave, Suite 2,
Burley, ID 83318-2170

Ph: (208) 677-2489

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Physical Therapist in Burley, ID

Dr. Tyler Carlen, DPT
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 1501 Hiland Ave, Burley, ID 83318
Phone: 208-677-6530    
Nicholas Lewis, PT, DPT
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 1945 Hiland Ave, Burley, ID 83318
Phone: 208-647-0024    Fax: 208-647-0239
Austin Stoddard, DPT
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 1263 Bennett Ave Ste 2, Burley, ID 83318
Phone: 208-678-1191    
Mr. Jeffrey Dwain Manion, MPT
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 933 Sandy Glen Ln, Burley, ID 83318
Phone: 402-290-4584    
Ryan Patrick Mccormick, P.T., D.P.T.
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 1945 Hiland Ave, Burley, ID 83318
Phone: 208-647-0024    Fax: 208-647-0239
Troy Michael Anderson, DPT
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 1501 Hiland Ave, Burley, ID 83318
Phone: 208-677-6530    
Antonino Roberto Russo,
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 1945 Hiland Ave, Burley, ID 83318
Phone: 208-647-0024    

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