Individual provider Active NPI

Clint T. Sestak, DPT

  • Physical Therapist
  • Springfield, IL
National Provider Identifier
1255987418
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070024471 Issued in IL
Practice address
3921 Pintail Dr
Springfield, IL 62711-6738
Phone
(217) 899-2270
Fax
(217) 953-4129
NPI assigned
Aug 14, 2019
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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 070024471 IL Primary

Addresses

Primary practice location

3921 Pintail Dr
Springfield, IL 62711-6738

Mailing address

3921 Pintail Dr
Springfield, IL 62711-6738
Phone (217) 899-2270

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190823001255 IL Practitioner - Physical Therapist in Private Practice 7113255456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Keldermans Therapy Services, PLLCGroup PAC ID 6507238276, 3 clinicians

Practice addresses (Care Compare)

3921 Pintail Dr
Springfield, IL 62711-6738
Phone (217) 899-2270

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Keldermans Therapy Services, PLLC Physical Therapist CurrentSince Jan 1, 2026 Accepting new patients

Locations

3921 Pintail Dr
Springfield, IL 62711
Phone (217) 572-2286

4000 Westgate Dr
Springfield, IL 62711
Phone (217) 726-6101

Interoperability endpoints

  • Direct secure messaging: clint.sestak.1@28977.direct.athenahealth.com

Organizations & group practices 1

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": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1255987418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 PINTAIL DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116738",
            "telephone_number": "217-899-2270",
            "fax_number": "217-953-4129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 PINTAIL DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116738",
            "telephone_number": "217-899-2270",
            "fax_number": "217-953-4129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SESTAK",
        "first_name": "CLINT",
        "middle_name": "T.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-14",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070024471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; 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.