Individual provider Active NPI

Clark Bearsmith, DPT

  • Orthopedic Physical Therapist
  • Albuquerque, NM
National Provider Identifier
1033686316
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT5321 Issued in NM
Practice address
7849 Tramway Blvd NE
Albuquerque, NM 87122-2515
Phone
(505) 821-3831
NPI assigned
Oct 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT5321 NM Primary

Addresses

Primary practice location

7849 Tramway Blvd NE
Albuquerque, NM 87122-2515

Mailing address

1206 Hermosa Dr SE
Albuquerque, NM 87108-4317
Phone (505) 231-7363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190115002969 NM Practitioner - Physical Therapist in Private Practice 2668718420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of New Mexico School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced Physical Therapy and Wellness LLCGroup PAC ID 9032427513, 50 clinicians

Practice addresses (Care Compare)

1540 Tramway Blvd NE
Suite E
Albuquerque, NM 87112-6194
Phone (505) 872-2276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Physical Therapy and Wellness, LLC Orthopedic CurrentSince Jan 24, 2019 Accepting new patients
Balanced Physical Therapy and Wellness, LLC Current Accepting new patients

Locations

1540 Tramway Blvd NE
Ste E
Albuquerque, NM 87112
Phone (505) 872-2276

7849 Tramway Blvd NE
Ste A
Albuquerque, NM 87122
Phone (505) 821-3831

6745 Academy Rd NE
Ste A
Albuquerque, NM 87109
Phone (505) 301-8434

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1033686316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 HERMOSA DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871084317",
            "telephone_number": "505-231-7363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7849 TRAMWAY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871222515",
            "telephone_number": "505-821-3831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARSMITH",
        "first_name": "CLARK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NM",
            "license": "PT5321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.