HAYDEN KLOCKENGA (DPT) – Physical Therapist, NPI 1073147161

HAYDEN KLOCKENGA (DPT) is a healthcare provider. based in Mount vernon, Illinois. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 070024984 (IL). The NPI Number for HAYDEN KLOCKENGA (DPT) is 1073147161

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
HAYDEN KLOCKENGA (DPT)
NPI
1073147161
Phone
(618) 242-3778
Address
4121 VETERANS MEMORIAL DR
Enumeration Date
27 February 2020
Last Update Date
27 February 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6188995001
Graduation Year
2019 (7 years ago)
PAC ID
4789012964
Group Practice PAC ID
3971764762
Professional Enrollment ID
I20200323000880
Address ID
IL628649665MO5100XNEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

5,030 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IL

Provider Addresses for HAYDEN KLOCKENGA (DPT)

  • 4121 VETERANS MEMORIAL DR

    MOUNT VERNON, IL 628646262

    Phone: (618) 242-3778

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-03-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200323000880IPhysical Therapist In Private PracticeILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes2,138224$0
97140Therapy procedure using manual technique, each 15 minutes351104$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care27270$0
97161Evaluation for physical therapy, typically 20 minutes153134$0
97035Application of ultrasound, each 15 minutes8137$0
View full utilization report →

Insurance plans in this area (ZIP 62864)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3971764762View full group profile
NameSpecialtyState
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
C H I R O P R A C T I CIL
Family PracticeIL
C H I R O P R A C T I CIL
Clinical PsychologistIN
Nurse PractitionerMN
Nurse PractitionerIL
Family PracticeIL

Reviews

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Frequently asked questions

Is there an official ID for HAYDEN KLOCKENGA (DPT) in U.S. healthcare records?
The official identifier for HAYDEN KLOCKENGA (DPT) is NPI 1073147161.
Is HAYDEN KLOCKENGA (DPT) shown as active in public data?
Registry records indicate HAYDEN KLOCKENGA (DPT) maintains an active NPI.
What expertise is attributed to HAYDEN KLOCKENGA (DPT)?
HAYDEN KLOCKENGA (DPT)'s specialty line reads Physical Therapist. Clinical services aligned with this taxonomy classification.
Is HAYDEN KLOCKENGA (DPT) located near Mount Vernon?
HAYDEN KLOCKENGA (DPT) currently maps to Mount Vernon, Illinois in this extract.
Does HAYDEN KLOCKENGA (DPT) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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