PROACTIVE PHYSICAL THERAPY PC
NPI 1609093434
Physical Therapist in Burley, ID
About Proactive Physical Therapy Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROACTIVE PHYSICAL THERAPY PC (NPI 1609093434) is a healthcare organization registered as a physical therapist in Burley, Idaho and active in the NPI registry since April 2007. The organization lists Raulan Young, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
- 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 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Proactive Physical Therapy Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Proactive Physical Therapy PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Proactive Physical Therapy PC's NPI number?
The NPI number for Proactive Physical Therapy PC is 1609093434. It was assigned to this organization in the NPPES registry on April 20, 2007.
Where is Proactive Physical Therapy PC located?
Proactive Physical Therapy PC is located at 2311 Park Ave Suite 2, Burley, ID 83318. The listed phone number is (208) 677-2489.
What is Proactive Physical Therapy PC's specialty?
The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.
Is Proactive Physical Therapy PC enrolled in Medicare?
Yes. Proactive Physical Therapy PC is registered in the Medicare PECOS enrollment system.
When is Proactive Physical Therapy PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Idaho, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Proactive Physical Therapy PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Physical Therapist in Private Practice) reassigns their Medicare billing to Proactive 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Proactive Physical Therapy PC accept?
Health plans from Molina Healthcare and University of Utah Health Plans list Proactive Physical Therapy PC 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 Proactive Physical Therapy PC was last updated on October 13, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Proactive Physical Therapy Pc · NPI 1609093434
Physical Therapist organization in Burley, Idaho. Organization record, active in the CMS NPPES registry since April 20, 2007.
## Identity
- **NPI:** 1609093434 (Entity type: Organization)
- **Enumerated:** April 20, 2007
- **Primary specialty:** Physical Therapist · taxonomy 225100000X
- **Organization subpart:** No
- **Authorized official:** Raulan Young, PRESIDENT
## Practice location
- **Address:** 2311 PARK AVE, SUITE 2, Burley, ID 83318-2170
- **Phone:** (208) 677-2489 · **Fax:** (208) 677-4023
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Idaho, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Physical Therapist in Private Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 13, 2010
- **Other identifiers:** Medicare ID-Type Unspecified 1654602 (ID); Medicaid 805407300 (ID)
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Source: [NPI Profile](https://npiprofile.com/npi/1609093434) · Data from the CMS NPPES public registry.