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

Lara A Bleck, PT

Individual provider Physical Therapist · NPI 1114002623

Lara A Bleck, PT is a Physical Therapist in Private Practice in Appleton, Wisconsin. Qualified in 1993, 33 years ago. Practices with Advanced Physical Therapy and Sports Medicine SC, a 61-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
33
Licensed in
WI
In the registry since
2006
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

1640 N Casaloma Dr
Appleton, WI 54913-8245
Phone: (920) 903-8545
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 6128024 (WI)

Record details

NPI number1114002623
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedOctober 25, 2006
Last updated in NPPESJuly 11, 2025
Certification dateJuly 11, 2025
Mailing address2105 E Enterprise Ave, Appleton, WI 54913-7862

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1993 (33 years in practice)
Group practice Advanced Physical Therapy And Sports Medicine Sc — 61 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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