PT Revolution Physical Therapy, PC
NPI 1467179663 · Physical Therapy Clinic/Center · South Lake Tahoe, CA
Enrolled with Medicare as Part B Supplier - Physical/Occupational Therapy Group in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
PT Revolution Physical Therapy, PC is a Physical Therapy Clinic/Center organization in South Lake Tahoe, CA (NPI 1467179663).
Provider details
- NPI number
- 1467179663
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jason Collin, Owner(530) 307-3316
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2022-10-27
- Last updated
- 2023-04-26
- Certified
- 2023-04-26
Frequently asked questions
- What is PT Revolution Physical Therapy, PC's NPI number?
- PT Revolution Physical Therapy, PC's National Provider Identifier (NPI) is 1467179663, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is PT Revolution Physical Therapy, PC?
- PT Revolution Physical Therapy, PC is classified in the NPPES registry as Physical Therapy Clinic/Center (Ambulatory Health Care Facilities).
- Where is PT Revolution Physical Therapy, PC located?
- PT Revolution Physical Therapy, PC's practice location on file with NPPES is 2038 Lake Tahoe Blvd, South Lake Tahoe, CA 96150-6499.
- What is PT Revolution Physical Therapy, PC's phone number?
- The practice phone number listed in the NPPES registry for PT Revolution Physical Therapy, PC is (530) 208-9910.
- Does PT Revolution Physical Therapy, PC accept Medicare?
- PT Revolution Physical Therapy, PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for PT Revolution Physical Therapy, PC?
- The authorized official listed on PT Revolution Physical Therapy, PC's NPPES record is Jason Collin, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is PT Revolution Physical Therapy, PC's NPI active?
- Yes — PT Revolution Physical Therapy, PC's NPI (1467179663) is active in the NPPES registry as of the last update on 2023-04-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.