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    OpenPayerNPI Medicare & MedicaidNathan Dailey
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    Nathan Dailey — Billing Profile & Reimbursement Data

    NPI 1811448632 · Simpsonville, SC · Physical Therapist

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    Nathan Dailey is a physical therapist provider located in Simpsonville, South Carolina. This profile covers 8 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationNathan Dailey
    Address200 E Trade St Ste 4
    CitySimpsonville
    StateSC
    ZIP29681
    TaxonomyPhysical Therapist
    NPI EnumeratedOctober 17, 2016

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$34.4K
    Medicaid$0

    Key Findings

    This provider is effectively single-payer in the available data: total Medicare revenue is $34.4K and there is no Medicaid billing on file, so Medicare dominates the recorded payer mix for this NPI. The absence of any Medicaid activity suggests the dataset should be interpreted as a Medicare-focused practice rather than a mixed Medicaid/Medicare operation.

    Revenue is highly concentrated in a small number of treatment codes: the top three Medicare codes (97140, 97530, 97112) account for 76.4% of this provider's total Medicare revenue. Those three codes generate $10.9K (97140), $8.6K (97530), and $7K (97112) respectively, signaling reliance on a narrow set of therapy services for most billing.

    The code mix points to a hands-on outpatient physical therapy practice focused on manual and activity-based treatments: 97140 (manual therapy) has 679 claims at $16 avg paid/claim, 97530 (therapeutic activities) has 343 claims at $25 avg paid/claim, and 97112 (neuromuscular reeducation) has 318 claims at $22 avg paid/claim. Presence of G0283 (146 claims, $7 avg paid/claim) indicates some use of unattended electrical stimulation within therapy plans, while evaluation codes (97161/97162/97163) appear but at much lower volumes.

    Competitive standing by national Medicare rank is modest to typical across the top services: 97140 ranks #12011 of 65133 (82th percentile) but is described as "typical, unremarkable volume for this code," 97530 ranks #31393 of 62717 (50th percentile; "typical, unremarkable volume"), and 97112 ranks #28942 of 61940 (53th percentile; "typical, unremarkable volume"). These ranks indicate the provider is not a dominant national player for these codes but sits within normal peer benchmarks, with 97140 relatively stronger by percentile.

    Evaluation services are a smaller part of billed activity and sit at lower national percentiles: 97162 (17 claims, $79 avg paid/claim) ranks #26485 of 35551 (22th percentile), 97163 (14 claims, $76 avg paid/claim) ranks #4829 of 6562 (20th percentile), and 97161 (15 claims, $70 avg paid/claim) ranks #30154 of 35745 (13th percentile). The lower percentiles and small claim counts for evaluation codes suggest this NPI bills predominantly for treatment sessions rather than initial or complex evaluations.

    Statistically, there are no flagged extreme outliers in the reported Medicare activity: most codes are labeled in the source as "typical, unremarkable volume for this code," and no code is described as notably above typical or extreme within the provided ranks. That pattern, combined with total Medicare revenue of $34.4K, positions the provider as a modest-scale, treatment-focused practitioner rather than a high-volume or specialty outlier.

    The provider has an established enrollment history with the Medicare program, with NPI enumeration dated 2016-10-17 (~10 years ago), which supports interpreting the current billing profile as reflective of several years of operation rather than a new entrant. Steady tenure plus the observed code mix implies an ongoing outpatient therapy workflow centered on repeat treatment encounters.

    Operationally, the claim counts emphasize recurring therapy sessions: 679 claims for 97140 and 343 claims for 97530 are the largest single-code claim totals reported, which aligns with a practice model delivering frequent, procedure-level therapy interventions. For contracting or network planning, this suggests the provider will be most relevant for coverage and rate discussions around manual therapy, therapeutic activities, and neuromuscular reeducation rather than evaluation-heavy or Medicaid-focused services.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    8 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    97140Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…680$20$10.9K
    97530The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.340$30$8.6K
    97112Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…320$20$7K
    97110Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…220$20$3.7K
    97162The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…20$80$1.3K
    97163The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history of a patient with three or more personal factors that may affect care, assess a clinical…10$80$1.1K
    97161The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…20$70$1.1K
    G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care150$10$1K

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    8 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    9753011,250600$20$20K
    9711011,390710$20$19.2K
    971121870250$20$8.2K
    9714011,100240$20$6.9K
    97161160030$70$3.6K
    97162166030$70$2.7K
    G02831260150$10$2.7K
    97163118030$70$2.6K

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Nathan Dailey, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Apple Physical Therapy, LLCWAPhysical Therapist$0$31.3M
    Ati Holdings, LLCMDPhysical Therapy Clinic/Center$0$30.3M
    Prisma Health-upstateSCDevelopmental Disabilities Clinic/Center$0$19.7M
    Greenville Proaxis Therapy, LLCSCPhysical Therapist$0$7.9M
    Courtney FochtSCPhysical Therapist$267.9K$0
    Daniel AltmanMDPhysical Therapist$230.9K$24.9K
    Eric LesniakPAPhysical Therapist$210.7K$0
    Tyee CharltonCAPhysical Therapist$95.5K$60.5K
    Phillip TyreDEPhysical Therapist$142.9K$0
    Andrew RussellPAPhysical Therapist$127.5K$0

    Nearby Providers

    Other providers in the same ZIP code as Nathan Dailey, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Heartland Hospice Services LLCSCCommunity Based Hospice Care Agency$0$8.6M
    Prisma Health-upstateSCGeneral Acute Care Hospital$0$8.3M
    South Carolina Dept Of Mental Health Accounting OfficeSCMental Health Clinic/Center (Including Community Mental Health Center)$0$7.1M
    Aging With Flair LLCSCOccupational Therapist$0$4.7M
    Excalibur Youth Services, LLC.SCPsychiatric Residential Treatment Facility$0$4.6M
    Holly Tree Pediatric DentistrySCPediatric Dentistry$0$4M
    William LongSCPodiatrist$666.1K$0
    Anthony DinicolaSCPain Medicine (Physical Medicine & Rehabilitation) Physician$552K$0
    Philip WessingerSCOrthopaedic Surgery Physician$185.8K$0
    Chad BraceySCFoot & Ankle Surgery Podiatrist$152.9K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. South Carolina Distribution
    Nathan Dailey — 0 of 8 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Carolina