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

Michael James Klobucher, PT, DPT, OCS, CMPT

Individual provider Physical Therapist · NPI 1396039541

Michael James Klobucher, PT, DPT, OCS, CMPT is a Physical Therapist in Private Practice in Rockford, Michigan. Qualified in 2011, 15 years ago. Practices with Shoreline Sport and Spine PLLC, a 45-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
15
Licensed in
MI
In the registry since
2011
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

65 S Main St Ste C
Rockford, MI 49341-1286
Phone: (616) 866-8084
Fax: (616) 866-8085
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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 5501015559 (MI)

Record details

NPI number1396039541
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT , OCS , CMPT
Sole proprietorNo
NPI enumeratedJune 6, 2011
Last updated in NPPESJuly 1, 2021
Certification dateJuly 1, 2021

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Shoreline Sport And Spine Pllc — 45 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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