ALEXANDRA RAE PETERSEN PT, DPT, CSCS
NPI 1790645232
Physical Therapist in New York, NY

Active since November 17, 2025Accepts Medicare Assignment
30 BROAD ST, NEW YORK, NY 10004(646) 790-7454 Get Directions Write a Review

NPPES record last updated: November 17, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Alexandra Rae Petersen Pt, Dpt, Cscs NPPES

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

ALEXANDRA RAE PETERSEN PT, DPT, CSCS (NPI 1790645232) is an individual physical therapist in New York, New York, licensed in New York (055426) and active in the NPI registry since November 2025. She is a graduate of Other (2024).

NPPES Registry Identity

NPI1790645232
Entity TypeIndividualFemale
Primary Taxonomy225100000X
Provider Legal NameALEXANDRA RAE PETERSENCredential: PT, DPT, CSCS
Location Address30 BROAD STNew York, NY 10004-2304
Mailing Address102 Madison Ave Fl 8New York, NY 10016-7584 · (212) 759-2282 · Fax (212) 379-2123
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateNovember 17, 2025
NPPES CertifiedNovember 17, 2025
NPI 1790645232 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
License Licensed in NY · 055426
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.
30 BROAD ST, New York, NY 10004

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Alexandra Rae Petersen Pt, Dpt, Cscs is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5496238388
PECOS Enrollment IDI20260310000704

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10004 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
30 BROAD ST
NEW YORK, NY 10004
Physical Therapist
30 BROAD ST
NEW YORK, NY 10004
Physical Therapist
30 BROAD ST, 12TH FLOOR
NEW YORK, NY 10004
Chiropractor (Sports Physician)
30 BROAD ST
NEW YORK, NY 10004
Physical Therapist
30 BROAD ST, 12TH FLOOR
NEW YORK, NY 10004
Physical Therapist
30 BROAD ST
NEW YORK, NY 10004
Physical Therapist
30 BROAD ST, LEVEL A
NEW YORK, NY 10004
Nurse Practitioner
30 BROAD ST, 45TH FLOOR
NEW YORK, NY 10004

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 Alexandra Petersen's NPI number?

The NPI number for Alexandra Petersen is 1790645232. It was assigned to this individual provider in the NPPES registry on November 17, 2025.

Where is Alexandra Petersen located?

Alexandra Petersen practices at 30 Broad St, New York, NY 10004. The listed phone number is (646) 790-7454.

What is Alexandra Petersen's specialty?

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

Is Alexandra Petersen enrolled in Medicare?

Yes. Alexandra Petersen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Alexandra Petersen was last updated on November 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.