Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gracie Clickovich, DPT

Individual provider Physical Therapist · NPI 1144011586

Gracie Clickovich, DPT is a Physical Therapist in Private Practice in Fort Wayne, Indiana. Qualified in 2025, 1 year ago. Practices with Protailored Physical Therapy LLC, a 23-clinician group and accepts Medicare assignment.

Years since qualifying
1
In the registry since
2025
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

12722 Tonkel Rd Ste 102
Fort Wayne, IN 46845-8201
Phone: (260) 739-0300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1144011586
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorNo
NPI enumeratedMay 15, 2025
Last updated in NPPESMay 15, 2025
Certification dateMay 15, 2025
Mailing address12722 Tonkel Rd Ste 102, Fort Wayne, IN 46845-8201

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Protailored Physical Therapy Llc — 23 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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