POCATELLO PHYSICAL THERAPY
NPI 1548808637
Physical Therapist in Pocatello, ID

Active since December 19, 2019
333 N 18TH AVE STE D2, POCATELLO, ID 83201(208) 232-6490(208) 234-4805 Get Directions Write a Review

NPPES record last updated: December 19, 2019. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Pocatello Physical Therapy NPPES

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

POCATELLO PHYSICAL THERAPY (NPI 1548808637) is a healthcare organization registered as a physical therapist in Pocatello, Idaho and active in the NPI registry since December 2019. The organization lists Randy C. Sidwell, Owner, Pt, as its authorized official.

NPPES Registry Identity

NPI1548808637
Entity TypeOrganization
Primary Taxonomy225100000X
Legal Business NamePOCATELLO PHYSICAL THERAPY
Location Address333 N 18TH AVE STE D2Pocatello, ID 83201-3358
Mailing Address333 N 18th Ave Ste D2Pocatello, ID 83201-3358 · (208) 232-6490 · Fax (208) 234-4805
Fax(208) 234-4805
Organization SubpartNo
Authorized OfficialRandy C. SidwellOwner, Pt · (208) 232-6490
Enumeration DateDecember 19, 2019
✔ NPI 1548808637 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • 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.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
333 N 18TH AVE STE D2, Pocatello, ID 83201

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Pocatello Physical Therapy, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Physical Therapist in Private Practice
NPI 1962547257
333 N 18TH AVE STE D2
Pocatello, ID 83201
(208) 232-6490
✔ Accepts MedicareSame address
Physical Therapist in Private Practice
NPI 1477740587
330 S 4TH AVE
Pocatello, ID 83201
(208) 221-6506
✔ Accepts Medicare1.0 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 Pocatello Physical Therapy's NPI number?

The NPI number for Pocatello Physical Therapy is 1548808637. It was assigned to this organization in the NPPES registry on December 19, 2019.

Where is Pocatello Physical Therapy located?

Pocatello Physical Therapy is located at 333 N 18th Ave Ste D2, Pocatello, ID 83201. The listed phone number is (208) 232-6490.

What is Pocatello Physical Therapy's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Pocatello Physical Therapy enrolled in Medicare?

Yes. Pocatello Physical Therapy is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pocatello Physical Therapy?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Physical Therapist in Private Practice, reassign their Medicare billing to Pocatello Physical Therapy. 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, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Pocatello Physical Therapy accept?

Health plans from Moda Health Plan, Inc. and Molina Healthcare list Pocatello Physical Therapy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pocatello Physical Therapy was last updated on December 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.