MR. ADAM CLARK WAGGONER (D.P.T.) – Physical Therapist, NPI 1629453139

MR. ADAM CLARK WAGGONER (D.P.T.) is a healthcare provider. based in Seattle, Washington. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials D.P.T.. They hold a License No. PT60594917 (WA). The NPI Number for MR. ADAM CLARK WAGGONER (D.P.T.) is 1629453139

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
MR. ADAM CLARK WAGGONER (D.P.T.)
NPI
1629453139
Phone
(206) 524-5115
Address
408 NE 72ND ST
Enumeration Date
26 July 2015
Last Update Date
30 November 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2067888807
Graduation Year
2016 (10 years ago)
PAC ID
9234577172
Group Practice PAC ID
2163781634
Professional Enrollment ID
I20240410003541
Address ID
WA981335315SH17012NXXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

3,527 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WA

Provider Addresses for MR. ADAM CLARK WAGGONER (D.P.T.)

  • 408 NE 72ND ST

    SEATTLE, WA 981155409

    Phone: (206) 524-5115

    Fax: (206) 524-2456

    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: 2024-04-10

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
I20240410003541IPhysical 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.

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

Insurance plans in this area (ZIP 98115)

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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: 2163781634View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeAL
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA
-WA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA
-WA
Physical Therapist In Private PracticeIL

Reviews

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Frequently asked questions

How do I look up MR. ADAM CLARK WAGGONER (D.P.T.) by NPI?
Use NPI 1629453139 when you need to reference MR. ADAM CLARK WAGGONER (D.P.T.) in forms, claims, or directories.
Is MR. ADAM CLARK WAGGONER (D.P.T.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize MR. ADAM CLARK WAGGONER (D.P.T.)'s specialty in plain language?
Clinically, the directory lists MR. ADAM CLARK WAGGONER (D.P.T.) with Physical Therapist. Clinical services aligned with this taxonomy classification.
Where does public data place MR. ADAM CLARK WAGGONER (D.P.T.)?
The snapshot lists Seattle, Washington for MR. ADAM CLARK WAGGONER (D.P.T.); download NPPES for the complete set.
How can I contact MR. ADAM CLARK WAGGONER (D.P.T.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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