CHARLES N DECLEENE (PT) – Physical Therapist, NPI 1326002148

CHARLES N DECLEENE (PT) is a healthcare provider. based in Kewaunee, Wisconsin. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 10376-24 (WI). The NPI Number for CHARLES N DECLEENE (PT) is 1326002148

Main info

Male
22 Years Of Experience
Accepts Medicare Assignment
Name
CHARLES N DECLEENE (PT)
NPI
1326002148
Phone
(920) 388-4640
Address
575 4th St
Enumeration Date
17 April 2006
Last Update Date
3 February 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9204337864
Graduation Year
2004 (22 years ago)
PAC ID
2365457538
Group Practice PAC ID
8820900749
Professional Enrollment ID
I20060208000732
Address ID
WI543012878GR2801XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,990 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WI

Provider Addresses for CHARLES N DECLEENE (PT)

  • 575 4th St

    Kewaunee, WI 542161785

    Phone: (920) 388-4640

    Type: Location

  • 555 Redbird Cir

    DE Pere, WI 541157977

    Phone: (920) 338-6870

    Fax: (920) 338-6879

    Type: Location

  • PO box, Russell Road, Paoli, Tredyffrin Township, Chester County, Pennsylvania, 19301, United States

    GREEN BAY, WI 543052487

    Phone: (920) 445-7210

    Fax: (920) 445-7289

    Type: Mailing

  • Bellin Health Titletown Sports Medicine and Orthopedics, 1970, South Ridge Road, Green Bay, Brown County, Wisconsin, 54304, United States

    GREEN BAY, WI 543044125

    Phone: (920) 430-4888

    Fax: (920) 430-4889

    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: 2006-02-08

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
I20060208000732IPhysical Therapist In Private PracticeWITBD

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 minutes38333$0
97140Therapy procedure using manual technique, each 15 minutes4015$0
97161Evaluation for physical therapy, typically 20 minutes2522$0
View full utilization report →

Insurance plans in this area (ZIP 54216)

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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: 8820900749View full group profile
NameSpecialtyState
Family PracticeWI
-WI
Nurse PractitionerWI
Physical Therapist In Private PracticeWI
-WI
-WI
O B S T E T R I C S/ G Y N E C O L O G YWI
Nurse PractitionerWA
Certified Registered Nurse Anesthetist (Crna)WI
Physical Therapist In Private PracticeWI

Reviews

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Frequently asked questions

Is there an official ID for CHARLES N DECLEENE (PT) in U.S. healthcare records?
The official identifier for CHARLES N DECLEENE (PT) is NPI 1326002148.
Would CHARLES N DECLEENE (PT) appear as active to a payer?
You can treat CHARLES N DECLEENE (PT) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe CHARLES N DECLEENE (PT)'s focus?
For CHARLES N DECLEENE (PT), the primary taxonomy reads as Physical Therapist. Clinical services aligned with this taxonomy classification.
Is CHARLES N DECLEENE (PT) associated with Kewaunee?
Public fields place CHARLES N DECLEENE (PT) around Kewaunee, Wisconsin. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for CHARLES N DECLEENE (PT) is noted as April 17, 2006 where the registry provides it.

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