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

Lyle Melvin Andersen, PT

Individual provider Physical Therapist · NPI 1265413918

Lyle Melvin Andersen, PT is a Physical Therapist in Private Practice in Modesto, California. Qualified in 1969, 57 years ago. Practices with Andersen Physical Therapy Inc, an 11-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
57
Licensed in
CA
In the registry since
2005
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

1917 Coffee Rd
Modesto, CA 95355-2704
Phone: (209) 549-4626
Fax: (209) 549-4625
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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 PT5278 (CA)

Record details

NPI number1265413918
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedNovember 9, 2005
Last updated in NPPESApril 17, 2017
Mailing address1917 Coffee Rd, Modesto, CA 95355-2704

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1969 (57 years in practice)
Group practice Andersen Physical Therapy Inc — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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