ANDERSEN PHYSICAL THERAPY, INC
NPI 1225029630
Physical Therapist in Modesto, CA
About Andersen Physical Therapy, Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANDERSEN PHYSICAL THERAPY, INC (NPI 1225029630) is a healthcare organization registered as a physical therapist in Modesto, California and active in the NPI registry since November 2005. The organization lists Lyle Melvin Andersen, Co Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Other Identifiers 7
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Andersen Physical Therapy, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
13Medicare enrollment records show 13 clinicians reassign Medicare billing to Andersen Physical Therapy, Inc, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 7 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 2
Clinicians, nearest first (13)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Andersen Physical Therapy, Inc's NPI number?
The NPI number for Andersen Physical Therapy, Inc is 1225029630. It was assigned to this organization in the NPPES registry on November 3, 2005.
Where is Andersen Physical Therapy, Inc located?
Andersen Physical Therapy, Inc is located at 1917 Coffee Rd, Modesto, CA 95355. The listed phone number is (209) 549-4626.
What is Andersen Physical Therapy, Inc's specialty?
The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.
Is Andersen Physical Therapy, Inc enrolled in Medicare?
Yes. Andersen Physical Therapy, Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Andersen Physical Therapy, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 13 clinicians in 2 Medicare specialties reassign their Medicare billing to Andersen Physical Therapy, Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Occupational Therapist in Private Practice (7) and Physical Therapist in Private Practice (6). Of these, 2 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Andersen Physical Therapy, Inc was last updated on April 17, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Andersen Physical Therapy, Inc · NPI 1225029630
Physical Therapist organization in Modesto, California. Organization record, active in the CMS NPPES registry since November 3, 2005.
## Identity
- **NPI:** 1225029630 (Entity type: Organization)
- **Enumerated:** November 3, 2005
- **Primary specialty:** Physical Therapist · taxonomy 225100000X
- **Organization subpart:** No
- **Authorized official:** Lyle Andersen, CO OWNER
## Practice location
- **Address:** 1917 COFFEE RD, Modesto, CA 95355-2704
- **Phone:** (209) 549-4626 · **Fax:** (209) 549-4625
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 13 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Occupational Therapist in Private Practice (7), Physical Therapist in Private Practice (6); 2 practice at this address and 7 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 17, 2017
- **Other identifiers:** Medicare NSC 4185520001 (CA); Medicare PIN YYY48495Y (CA); Medicare NSC 4185520002; and 4 more
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Source: [NPI Profile](https://npiprofile.com/npi/1225029630) · Data from the CMS NPPES public registry.