Dr Kenneth John Clark Jr, DPT in Saint Petersburg, FL - Medicare Physical Therapist Provider

Dr Kenneth John Clark Jr, DPT is a medicare enrolled "Physical Therapist" provider in Saint Petersburg, Florida. His current practice location is 6619 1st Ave S, Saint Petersburg, Florida. You can reach out to his office (for appointments etc.) via phone at (417) 315-5577.

Dr Kenneth John Clark Jr is licensed to practice in Florida (license number PT32691) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1144740580.

Contact Information

	Dr Kenneth John Clark Jr, DPT
	6619 1st Ave S, Saint Petersburg, FL 33707-1305
	(417) 315-5577
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Kenneth John Clark Jr
Gender	Male
Speciality	Physical Therapist
Location	6619 1st Ave S, Saint Petersburg, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1144740580
Provider Enumeration Date: 06/27/2017
Last Update Date: 02/03/2022

Medicare PECOS Information:

PECOS PAC ID: 5092088336
Enrollment ID: I20170907001825

Medical Identifiers

Medical identifiers for Dr Kenneth John Clark Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1144740580	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	PT32691 (Florida)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kenneth John Clark Jr allows following entities to bill medicare on his behalf.

Provider Name	Purpose Physical Therapy And Wellness Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1003422064 PECOS PAC ID: 9931572435 Enrollment ID: O20230303000851

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kenneth John Clark Jr is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Kenneth John Clark Jr, DPT 1190 28th Ave N, 1/2, Saint Petersburg, FL 33704-1205 Ph: (417) 315-5777	Dr Kenneth John Clark Jr, DPT 6619 1st Ave S, Saint Petersburg, FL 33707-1305 Ph: (417) 315-5577

Reviews and Comments

Physical Therapist in Saint Petersburg, FL

Constance Jean Kershner, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5101 Brittany Dr S Ste 16, Saint Petersburg, FL 33715 Phone: 727-308-9848 Fax: 727-502-6027
Cherie Lynne Waring, MSPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 352 22nd Ave Se, Saint Petersburg, FL 33705 Phone: 727-894-2355
Dr. Kelli Anne Faville, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6775 40th Ave N, Saint Petersburg, FL 33709 Phone: 727-803-1002
Sly Edwards, Physical Therapist Medicare: Medicare Enrolled Practice Location: 8950 Dr Martin Luther King Jr St N, Saint Petersburg, FL 33702 Phone: 727-520-0800
Dr. Mary Wesley Garner, D.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 801 6th St S, Saint Petersburg, FL 33701 Phone: 727-767-4257
Beach Baby Pediatric Therapy, Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5042 42nd St S, Saint Petersburg, FL 33711 Phone: 727-871-2784

Dr Kenneth John Clark Jr, DPT - Medicare Physical Therapist in Saint Petersburg, FL