MARY-KATHERINE CLARK – Physical Therapist, NPI 1487310934

MARY-KATHERINE CLARK is a healthcare provider. based in Middlebury, Vermont. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 040.0134346 (VT). The NPI Number for MARY-KATHERINE CLARK is 1487310934

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
MARY-KATHERINE CLARK
NPI
1487310934
Phone
Not provided
Address
PO BOX 754
Enumeration Date
9 November 2021
Last Update Date
9 November 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8023887259
Graduation Year
2021 (5 years ago)
PAC ID
5193165280
Group Practice PAC ID
4587983374
Professional Enrollment ID
I20240507001540
Address ID
VT054721045NE254XXHWYX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

300 PHYSICAL THERAPIST IN PRIVATE PRACTICE in VT

Provider Addresses for MARY-KATHERINE CLARK

  • PO BOX 754

    MIDDLEBURY, VT 057530754

    Phone:

    Type: Mailing

  • 254 ETHAN ALLEN HWY

    NEW HAVEN, VT 054721045

    Phone: (802) 388-7259

    Type: Location

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: 2024-05-07

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
I20240507001540IPhysical Therapist In Private PracticeVTTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 05753)

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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: 4587983374View full group profile
NameSpecialtyState
Qualified Speech Language PathologistVT
Physical Therapist In Private PracticeVT
Physical Therapist In Private PracticeMA

Reviews

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Frequently asked questions

How do I look up MARY-KATHERINE CLARK by NPI?
Use NPI 1487310934 when you need to reference MARY-KATHERINE CLARK in forms, claims, or directories.
Is MARY-KATHERINE CLARK currently active in the NPI registry?
CMS-published data lists MARY-KATHERINE CLARK as an active registrant.
What kind of provider is MARY-KATHERINE CLARK?
The page reflects Physical Therapist for MARY-KATHERINE CLARK. Clinical services aligned with this taxonomy classification.
Where is MARY-KATHERINE CLARK's primary listing?
We display Middlebury, Vermont because that is what the record indicates for MARY-KATHERINE CLARK.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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