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

Kelly Jane Tangen, PT

Individual provider Physical Therapist · NPI 1083710461

Kelly Jane Tangen, PT is a Physical Therapist in Private Practice in Tampa, Florida. Qualified in 2004, 22 years ago. Practices with Optimal Performance and Physical Therapies St Joes LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
22
Licensed in
FL
In the registry since
2006
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

3903 Northdale Blvd Ste 111W
Tampa, FL 33624-1864
Phone: (813) 418-7350
Fax: (813) 265-2504
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT21694 (FL)

Record details

NPI number1083710461
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedSeptember 15, 2006
Last updated in NPPESJune 2, 2014

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Optimal Performance And Physical Therapies St. Joes Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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