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

Alexandra Rae Petersen, PT, DPT, CSCS

Individual provider Physical Therapist · NPI 1790645232

Alexandra Rae Petersen, PT, DPT, CSCS is registered under Physical Therapist in Private Practice in New York, New York. Qualified in 2024, 2 years ago. Practices with Spear Physical and Occupational Therapy, LLC, a 577-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
2
Licensed in
NY
In the registry since
2025
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

30 Broad St
New York, NY 10004-2304
Phone: (646) 790-7454
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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 055426 (NY)

Record details

NPI number1790645232
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT , DPT , CSCS
Sole proprietorNo
NPI enumeratedNovember 17, 2025
Last updated in NPPESNovember 17, 2025
Certification dateNovember 17, 2025

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Spear Physical And Occupational Therapy, Llc — 577 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Colleagues at Spear Physical and Occupational Therapy, LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 577 clinicians in the practice; 12 are shown here.

Other providers in New York