Individual provider Active NPI

Andrew Clark, DPT

  • Physical Therapist
  • Scottsdale, AZ
National Provider Identifier
1255114104
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-33161 Issued in AZ
Practice address
9364 E Raintree Dr
Scottsdale, AZ 85260-2200
Phone
(480) 661-1124
NPI assigned
Aug 15, 2023
Last updated
Aug 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X LPT-33161 AZ Primary

Addresses

Primary practice location

9364 E Raintree Dr
Scottsdale, AZ 85260-2200

Mailing address

9494 E Redfield Rd
Scottsdale, AZ 85260-3757

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230911001054 AZ Practitioner - Physical Therapist in Private Practice 4880058833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endurance Rehabilitation LLCGroup PAC ID 6103861687, 13 clinicians

Practice addresses (Care Compare)

9376 E Bahia Dr
Suite 103
Scottsdale, AZ 85260-1532
Phone (480) 556-8406

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-33161AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Endurance Rehabilitation LLC Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients
Endurance Rehabilitation LLC CurrentSince Jan 6, 2025 Accepting new patients

Locations

9376 E Bahia Dr
Ste 103
Scottsdale, AZ 85260
Phone (480) 556-8406

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1255114104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9494 E REDFIELD RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9364 E RAINTREE DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602200",
            "telephone_number": "480-661-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANDREW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-33161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.