Paul A Clark, PT, DPT
Individual provider Active NPI Physical Therapist · Levelland, TX
NPI 1235540931 · NPPES record last updated May 15, 2014
Key facts
- NPI
- 1235540931
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1242809 (TX)
- Practice address
- 410 Avenue G
Levelland, TX 79336-3719 - Phone
- (806) 897-0540
- Fax
- (806) 897-0542
- NPI assigned
- May 15, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Athletico LTD
Practice addresses (Care Compare)
8270 S Houghton Rd
Suite 180
Tucson, AZ 85747-9717
Phone (520) 664-1430
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.32 of 100
- Quality
- 84.44
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 70.78
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190422001025 | AZ | Practitioner - Physical Therapist in Private Practice | 4082830310 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1242809 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athletico LTD | Physical Therapist | Current |
Accepting new patients |
| Athletico LTD | Physical Therapist | Current |
Accepting new patients |
Locations
6070 W Bell Rd
Ste A103
Glendale, AZ 85308
Phone (602) 782-3965
8270 S Houghton Rd
Ste 180
Tucson, AZ 85747
Phone (520) 664-1430
6970 N Oracle Rd
Ste 130
Tucson, AZ 85704
Phone (520) 219-5825
1686 W Valencia Rd
Ste 100
Tucson, AZ 85746
Phone (520) 573-1443
600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250
Interoperability endpoints
- paul.clark.p6@direct.athleticoltd.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1242809 | TX | Yes |
Addresses
Primary practice location
410 Avenue G
Levelland, TX 79336-3719
Mailing address
5217 82ND St
Suite 104
Lubbock, TX 79424-2827
Phone (806) 687-4311
Other providers in Levelland, TX
- Brenna Paige Chaves
- Children'S Hope Residential Services, Inc.
- Children'S Hope Residential Services, Inc.
- Children'S Hope Residential Services, Inc.
- Children'S Hope Residential Services, Inc.-Cpa
- Nora Contreras
- Jonna Rhnea Cook
- Pamala Joyce Cooper
- Roda Cruz
- CVS Pharmacy Inc
All providers in Levelland, TX · Physical Therapist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.