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

Michael R. Koch, PT

Individual provider Physical Therapist · NPI 1225058878

Michael R. Koch, PT is a Physical Therapist in Private Practice in Waupaca, Wisconsin. Qualified in 1991, 35 years ago. Practices with Spine and Sport Physical Therapy of Waupaca LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
35
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

1948 Godfrey Dr
Waupaca, WI 54981-7908
Phone: (715) 340-5383
Fax: (715) 258-7773
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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 4135-024 (WI)

Record details

NPI number1225058878
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorYes
NPI enumeratedJuly 19, 2006
Last updated in NPPESOctober 11, 2018
Mailing address1439 Churchill St, Suite 102, Waupaca, WI 54981-2089

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1991 (35 years in practice)
Group practice Spine And Sport Physical Therapy Of Waupaca Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Waupaca