MICHAEL J CLARK (PT) – Physical Therapist, NPI 1306849955

MICHAEL J CLARK (PT) is a healthcare provider. based in Walla walla, Washington. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 2569 (OR). The NPI Number for MICHAEL J CLARK (PT) is 1306849955

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
MICHAEL J CLARK (PT)
NPI
1306849955
Phone
(509) 522-0114
Address
275 W TIETAN ST
Enumeration Date
27 May 2005
Last Update Date
15 September 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5095220114
Graduation Year
1992 (34 years ago)
PAC ID
7810982907
Group Practice PAC ID
6901797190
Professional Enrollment ID
I20170413002098
Address ID
WA993624363WA275XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:21State licenses:2Digital endpointsOther names

3,527 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WA

Provider Addresses for MICHAEL J CLARK (PT)

  • 275 W TIETAN ST

    WALLA WALLA, WA 993624363

    Phone: (509) 522-0114

    Fax: (509) 522-9868

    Type: Location

  • 214, East Birch Street, Walla Walla, Walla Walla County, Washington, 99362-5024, United States

    STE 4

    WALLA WALLA, WA 993623043

    Phone: (509) 522-0114

    Fax: (509) 522-9868

    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: 2017-04-13

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
I20170413002098IPhysical Therapist In Private PracticeWATBD

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 minutes2,526122$0
97140Therapy procedure using manual technique, each 15 minutes2,459115$0
97530Therapy procedure using functional activities2,029116$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care13537$0
97162Evaluation for physical therapy, typically 30 minutes10691$0
View full utilization report →

Insurance plans in this area (ZIP 99362)

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Provider's Procedures

MICHAEL J CLARK (PT) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYWA97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes2189127

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: 6901797190View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA

Reviews

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Frequently asked questions

What number should I use to identify MICHAEL J CLARK (PT) for billing?
Administrative and clinical systems typically use NPI 1306849955 for MICHAEL J CLARK (PT).
Should I treat MICHAEL J CLARK (PT) as an active provider?
Patients and plans typically see MICHAEL J CLARK (PT) as active in the national extract.
How should patients interpret MICHAEL J CLARK (PT)'s specialty?
The extract shows Physical Therapist for MICHAEL J CLARK (PT). Clinical services aligned with this taxonomy classification.
Can patients visit MICHAEL J CLARK (PT) in Walla Walla, Washington?
For routing, start with Walla Walla, Washington for MICHAEL J CLARK (PT), then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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