Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ETHAN REKEDAL DPT
NPI 1821961541
Physical Therapist in Casper, WY

Active since September 29, 2025PECOS Enrolled
4155 LEGION LN STE 1AND2, CASPER, WY 82609(307) 259-0508 Get Directions Write a Review

NPPES record last updated: October 26, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Ethan Rekedal Dpt NPPES

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

ETHAN REKEDAL DPT (NPI 1821961541) is an individual physical therapist in Casper, Wyoming, licensed in Wyoming (PT-2655) and active in the NPI registry since September 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1821961541
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameETHAN REKEDALCredential: DPT
Location Address4155 LEGION LN STE 1AND2Casper, WY 82609-1946
Mailing Address4155 Legion Ln Ste 1and2Casper, WY 82609-1946 · (307) 259-0508
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateSeptember 29, 2025
Last NPPES UpdateOctober 26, 2026
NPPES CertifiedOctober 26, 2026
✔ NPI 1821961541 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 WY · PT-2655
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.
4155 LEGION LN STE 1AND2, Casper, WY 82609

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan Rekedal Dpt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID143718247
PECOS Enrollment IDI20251021003579
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Ethan Rekedal reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Occupational Medicine
1661 SAINT ANTHONY AVE
Saint Paul, MN 55104
  • Reassigned Medicare billing, Minnesota enrollment
  • 197 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 82609 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
$87.12 typical visit price
range $56.42 – $170.72
Typical copayment $21.78 (range $14.10 – $42.68)
Most-billed visit code 99203
Established Patient
$70.32 typical visit price
range $18.19 – $139.32
Typical copayment $17.58 (range $4.54 – $34.83)
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.

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 Ethan Rekedal's NPI number?

The NPI number for Ethan Rekedal is 1821961541. It was assigned to this individual provider in the NPPES registry on September 29, 2025.

Where is Ethan Rekedal located?

Ethan Rekedal practices at 4155 Legion Ln Ste 1and2, Casper, WY 82609. The listed phone number is (307) 259-0508.

What is Ethan Rekedal's specialty?

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

Is Ethan Rekedal enrolled in Medicare?

Yes. Ethan Rekedal is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ethan Rekedal's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Rekedal reassigns Medicare benefits to Summit Orthopedics, Ltd. (Saint Paul, MN). The 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 Ethan Rekedal's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ethan Rekedal was last updated on October 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 days 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.