MR. KYLE JACKSON PT
NPI 1861597908
Physical Therapist in Petaluma, CA

Active since September 13, 2006Accepts Medicare Assignment
1310 CASA GRANDE RD, SUITE B, PETALUMA, CA 94954(707) 782-0921(707) 782-0926 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Kyle Jackson Pt NPPES

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

MR. KYLE JACKSON PT (NPI 1861597908) is an individual physical therapist in Petaluma, California, licensed in California (PT27666) and active in the NPI registry since September 2006. He is a graduate of Other (2001).

NPPES Registry Identity

NPI1861597908
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameMR. KYLE JACKSONCredential: PT
Location Address1310 CASA GRANDE RD, SUITE BPetaluma, CA 94954-5603
Mailing AddressPo Box 10Windsor, CA 95492-0010 · (707) 837-7980 · Fax (707) 837-7983
Fax(707) 782-0926
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateSeptember 13, 2006
Last NPPES UpdateJuly 9, 2007
NPI 1861597908 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 CA · PT27666
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.
1310 CASA GRANDE RD, Petaluma, CA 94954

Other Identifiers 4

Medicare UPINP69009CA
Medicare ID-Type UnspecifiedOPT276660CA · Individual Id # Medicare
OtherZZZ00793ZCA · Blue Shield Prov Grp #
OtherZZZ231187CA · Medicare Grp Id#

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

Mr. Kyle Jackson Pt 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 ID4385818772
PECOS Enrollment IDI20111121000821

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110
This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.
3,974 services128 patients
Therapy procedure using manual technique, each 15 minutes 97140
This therapy involves using hands-on techniques to help improve your body's movement and function. These techniques may include stretching, resistance exercises, or gentle pressure. Each session lasts 15 minutes and aims to relieve pain, promote healing, and improve your overall health.
1,424 services128 patients
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care G0283
Electrical stimulation is a therapy method where mild electrical pulses are used to treat pain or stimulate muscles in certain areas. It's not for wound care but is part of a broader therapy plan. It's safe, non-invasive, and can help improve overall health.
1,097 services105 patients
Application of blood vessel compression device 97016
A blood vessel compression device is applied to control bleeding and promote clotting after a procedure. This device applies pressure to your blood vessels, reducing the chance of excessive bleeding. It's a safe, standard part of many medical procedures.
702 services63 patients
Evaluation for physical therapy, typically 30 minutes 97162
An evaluation for physical therapy is a 30-minute session where a physical therapist assesses your current physical condition. They'll examine your strength, flexibility, balance, and mobility to identify areas needing improvement. This helps tailor a therapy plan to your specific needs.
132 services109 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94954 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
$96.16 typical visit price
range $63.04 – $187.01
Typical copayment $24.04 (range $15.76 – $46.75)
Most-billed visit code 99203
Established Patient
$77.94 typical visit price
range $21.02 – $153.40
Typical copayment $19.48 (range $5.25 – $38.35)
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 Kyle Jackson's NPI number?

The NPI number for Kyle Jackson is 1861597908. It was assigned to this individual provider in the NPPES registry on September 13, 2006.

Where is Kyle Jackson located?

Kyle Jackson practices at 1310 Casa Grande Rd Suite B, Petaluma, CA 94954. The listed phone number is (707) 782-0921.

What is Kyle Jackson's specialty?

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

Is Kyle Jackson enrolled in Medicare?

Yes. Kyle Jackson 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 Kyle Jackson was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.