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CONNOR REID CLARK PT
NPI 1003741729
Physical Therapist - Orthopedic in Everett, WA

Active since June 15, 2026Accepts Medicare Assignment
10511 19TH AVE SE STE B, EVERETT, WA 98208(425) 357-8885 Get Directions Write a Review

NPPES record last updated: June 15, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Connor Reid Clark Pt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONNOR REID CLARK PT (NPI 1003741729) is an individual orthopedic provider in Everett, Washington, licensed in Washington (PT.PT.70108290) and active in the NPI registry since June 2026. He is a graduate of Other (2026).

NPPES Registry Identity

NPI1003741729
Entity TypeIndividualMale
Primary Taxonomy2251X0800X
Provider Legal NameCONNOR REID CLARKCredential: PT
Location Address10511 19TH AVE SE STE BEverett, WA 98208-4279
Mailing Address2405 167th Pl SeBothell, WA 98012-8002 · (425) 953-6326
Phone(425) 357-8885
Sole ProprietorNo
Medical School CMSOtherGraduated 2026
Enumeration DateJune 15, 2026
NPPES CertifiedJune 15, 2026
✔ NPI 1003741729 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · OrthopedicRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251X0800X
License✔ Licensed in WA · PT.PT.70108290
Definition
A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.
10511 19TH AVE SE STE B, Everett, WA 98208
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Connor Reid Clark Pt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1254898562
PECOS Enrollment IDI20260806002471

Medicare Billing Reassignment

Medicare enrollment records show Connor Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Summit Rehabilitation PLLC
8.3 mi
Physical Therapy
9514 4TH ST NE UNIT 101
Lake Stevens, WA 98258
  • Reassigned Medicare billing, Washington enrollment
  • 102 clinicians in this Medicare group
NPI 1013648153 (206) 257-1514

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHEL SANNICANDRO DPT
Physical Therapist
10511 19TH AVE SE STE B
EVERETT, WA 98208
Snohomish County (425) 428-6027
KIM SAITO
Physical Therapy Assistant
10511 19TH AVE SE STE B
EVERETT, WA 98208
Snohomish County (425) 357-8885
DR. JOSEPH RIZK DPT
Physical Therapist
10511 19TH AVE SE STE B
EVERETT, WA 98208
Snohomish County (425) 372-7092
GREGORY ROBERT NEEDY PTA
Physical Therapy Assistant
10511 19TH AVE SE STE B
EVERETT, WA 98208
Snohomish County (425) 357-8885
MEGAN ELLEN JOHNSON DPT
Physical Therapist
10511 19TH AVE SE STE B
EVERETT, WA 98208
Snohomish County (425) 357-8885
DAYLENE ROSE WELCH PTA
Physical Therapy Assistant
10511 19TH AVE SE STE B
EVERETT, WA 98208
Snohomish County (425) 357-8885
JANET CHEN FOWLER MPT
Physical Therapist
10511 19TH AVE SE STE B
EVERETT, WA 98208
Snohomish County (425) 357-8885
SUMINDER BHANGAL
Occupational Therapist
10511 19TH AVE SE STE B
EVERETT, WA 98208
Snohomish County (425) 357-8885

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Connor Clark's NPI number?

The NPI number for Connor Clark is 1003741729. It was assigned to this individual provider in the NPPES registry on June 15, 2026.

Where is Connor Clark located?

Connor Clark practices at 10511 19th Ave SE Ste B, Everett, WA 98208. The listed phone number is (425) 357-8885.

What is Connor Clark's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.

Is Connor Clark enrolled in Medicare?

Yes. Connor Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Connor Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Connor Clark reassigns Medicare benefits to Summit Rehabilitation PLLC (Lake Stevens, WA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Connor Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Connor Clark was last updated on June 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.