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PT REVOLUTION PHYSICAL THERAPY, PC
NPI 1467179663
Clinic/Center - Physical Therapy in South Lake Tahoe, CA

Active since October 27, 2022
2038 LAKE TAHOE BLVD, SOUTH LAKE TAHOE, CA 96150(530) 208-9910(530) 285-2001 Get Directions Write a Review

NPPES record last updated: April 26, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Pt Revolution Physical Therapy, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PT REVOLUTION PHYSICAL THERAPY, PC (NPI 1467179663) is a healthcare organization registered as a physical therapy in South Lake Tahoe, California and active in the NPI registry since October 2022. The organization lists Jason Collin, Owner, as its authorized official.

NPPES Registry Identity

NPI1467179663
Entity TypeOrganization
Primary Taxonomy261QP2000X
Legal Business NamePT REVOLUTION PHYSICAL THERAPY, PC
Location Address2038 LAKE TAHOE BLVDSouth Lake Tahoe, CA 96150-6499
Mailing Address2038 Lake Tahoe BlvdSouth Lake Tahoe, CA 96150-6499 · (530) 208-9910 · Fax (530) 285-2001
Phone(530) 208-9910
Fax(530) 285-2001
Organization SubpartNo
Authorized OfficialJason CollinOwner · (530) 307-3316
Enumeration DateOctober 27, 2022
Last NPPES UpdateApril 26, 2023
NPPES CertifiedApril 26, 2023
✔ NPI 1467179663 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Physical TherapyAmbulatory Health Care Facilities
Taxonomy Code261QP2000X
Definition
An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists and physical therapist assistants are licensed health care professionals who are experts in the movement system and help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life. Their services prevent, minimize, or eliminate impairments of body functions and structures, activity limitations, and participation restrictions. Physical therapy is provided for individuals of all ages who have or may develop impairments, activity limitations, and participation restrictions related to (1) conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems or (2) the negative effects attributable to unique personal and environmental factors as they relate to human performance.
2038 LAKE TAHOE BLVD, South Lake Tahoe, CA 96150
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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pt Revolution Physical Therapy, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

14

Medicare enrollment records show 14 clinicians reassign Medicare billing to Pt Revolution Physical Therapy, PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 7 within 10 miles. They are listed nearest first.

Clinicians, nearest first (14)

Ian Anderson, DPT
Physical Therapist in Private Practice
NPI 1447769997
2038 LAKE TAHOE BLVD
South Lake Tahoe, CA 96150
(530) 208-9910
✔ Accepts MedicareSame address
Justin Dorn, DPT
Physical Therapist in Private Practice
NPI 1245776327
2038 LAKE TAHOE BLVD
South Lake Tahoe, CA 96150
(530) 208-9910
✔ Accepts MedicareSame address
Sarah Pendergrast, DPT
Physical Therapist in Private Practice
NPI 1528635489
2038 LAKE TAHOE BLVD
South Lake Tahoe, CA 96150
(530) 208-9910
✔ Accepts MedicareSame address
Alyssa Andres
Physical Therapist in Private Practice
NPI 1760216360
2038 LAKE TAHOE BLVD
South Lake Tahoe, CA 96150
(530) 208-9910
✔ Accepts Medicare0.1 mi
Erik Silverman, PT
Physical Therapist in Private Practice
NPI 1003792441
2038 LAKE TAHOE BLVD
South Lake Tahoe, CA 96150
(530) 208-9910
✔ Accepts Medicare0.1 mi
Jason Collin, PT
Physical Therapist in Private Practice
NPI 1366403933
2050 DUNLAP DR
South Lake Tahoe, CA 96150
(530) 208-9910
✔ Accepts Medicare0.1 mi
Joshua Foster, DPT
Physical Therapist in Private Practice
NPI 1437815883
593 TAHOE KEYS BLVD
South Lake Tahoe, CA 96150
(530) 208-9910
✔ Accepts Medicare1.1 mi
Kayla Neumann, DPT, PT
Physical Therapist in Private Practice
NPI 1891685871
40173 TRUCKEE AIRPORT RD STE 102
Truckee, CA 96161
(530) 999-5787
✔ Accepts Medicare29 mi
Jennifer Manning, DPT
Physical Therapist in Private Practice
NPI 1477168839
11053 DONNER PASS RD
Truckee, CA 96161
(530) 587-4790
✔ Accepts Medicare30 mi
Janet Kowalchick, MPT
Physical Therapist in Private Practice
NPI 1770542102
991 GOVERNOR DRIVE SUITE 104
El Dorado Hills, CA 95762
(760) 608-1873
✔ Accepts Medicare60 mi
Sarah Correll, PT, DPT
Physical Therapist in Private Practice
NPI 1407371685
263 N MATHILDA AVE
Sunnyvale, CA 94086
(408) 736-7600
✔ Accepts Medicare153 mi
Brianna Introcaso, BS, DPT
Physical Therapist in Private Practice
NPI 1194235218
1020 TIERRA DEL REY # 1
Chula Vista, CA 91910
(619) 585-7104
✔ Accepts Medicare464 mi
Harrison Hess, DPT
Physical Therapist in Private Practice
NPI 1326934548
180 S FRONTAGE RD W
Vail, CO 81657
(970) 476-2451
✔ Accepts Medicare731 mi
Marisa Esquivel, DPT
Physical Therapist in Private Practice
NPI 1407376460
9201 MONTGOMERY BLVD NE STE 302
Albuquerque, NM 87111
(505) 293-6262
788 mi

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 Pt Revolution Physical Therapy, PC's NPI number?

The NPI number for Pt Revolution Physical Therapy, PC is 1467179663. It was assigned to this organization in the NPPES registry on October 27, 2022.

Where is Pt Revolution Physical Therapy, PC located?

Pt Revolution Physical Therapy, PC is located at 2038 Lake Tahoe Blvd, South Lake Tahoe, CA 96150. The listed phone number is (530) 208-9910.

What is Pt Revolution Physical Therapy, PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Physical Therapy, with taxonomy code 261QP2000X.

Is Pt Revolution Physical Therapy, PC enrolled in Medicare?

Yes. Pt Revolution Physical Therapy, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pt Revolution Physical Therapy, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 14 clinicians, all in Physical Therapist in Private Practice, reassign their Medicare billing to Pt Revolution Physical Therapy, PC. 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. Of these, 3 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 Pt Revolution Physical Therapy, PC was last updated on April 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.