Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derrick Christopher Penticuff

Individual provider Physical Therapist · NPI 1770107179

Derrick Christopher Penticuff is a Physical Therapist in Private Practice in Pueblo, Colorado. Qualified in 2020, 6 years ago. Practices with Synergy Physical Therapy and Wellness, a 5-clinician group and accepts Medicare assignment.

Years since qualifying
6
In the registry since
2020
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Practice location Address checks out

4115 Club Manor Dr
Pueblo, CO 81008
Phone: (968) 568-9790
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1770107179
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 1, 2020
Last updated in NPPESApril 12, 2023
Certification dateApril 7, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Synergy Physical Therapy And Wellness — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Pueblo