Individual provider Active NPI

Ryan Patrick Haskell

  • Physical Therapist
  • Marysville, WA
National Provider Identifier
1003069725
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00009286 Issued in WA
Practice address
2901 174TH St NE
Marysville, WA 98271-4743
Phone
(360) 454-1945
Fax
(360) 454-1991
NPI assigned
Oct 25, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00009286 WA Primary

Addresses

Primary practice location

2901 174TH St NE
Marysville, WA 98271-4743

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (360) 454-1945

Other identifiers 10

IdentifierTypeStateIssuer
5311HAOtherWAREGENCE
8949261OtherWAL&I CRIME VICTIMS
0242005OtherWAL&I
5307HAOtherWAREGENCE
8951177OtherWAL&I CRIME VICTIMS
0248638OtherWAL&I
5309HAOtherWAREGENCE
5308HAOtherWAREGENCE
5305HAOtherWAREGENCE
8402620OtherWADSHS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121218000124 ID Practitioner - Physical Therapist in Private Practice 4688569320 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nichols Therapy Group P.C.Group PAC ID 0345229068, 8 clinicians

Practice addresses (Care Compare)

9652 W State St
Northstar Physical Therapy
Star, ID 83669-5858
Phone (208) 286-0766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
PT00009286WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Physical Therapy P C Physical Therapist CurrentSince Nov 24, 2021 Accepting new patients
Nichols Therapy Group PC Physical Therapist CurrentSince Aug 8, 2023 Accepting new patients
Erhardt Physical Therapy and Sports Medicine, LLC Physical Therapist PastSince May 11, 2016 Accepting new patients
McCall Physical Therapy, P.a. Physical Therapist Past Accepting new patients
Institute of Physical Therapy and Fitness Physical Therapist Past Accepting new patients
McMinnville Physical Therapy Physical Therapist PastSince Jul 6, 2009 Accepting new patients

Locations

7550 W Emerald St
Ste 101
Boise, ID 83704
Phone (208) 375-0666

678 Southway Ave
Lewiston, ID 83501
Phone (208) 746-1418

2005 12th Ave Rd
Nampa, ID 83686
Phone (208) 463-0022

9652 W State St
#T
Star, ID 83669
Phone (208) 286-0766

9652 W State St
Star, ID 83669
Phone (208) 286-0766

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1003069725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "360-454-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 174TH ST NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982714743",
            "telephone_number": "360-454-1945",
            "fax_number": "360-454-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASKELL",
        "first_name": "RYAN",
        "middle_name": "PATRICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-25",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "5311HA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I CRIME VICTIMS",
            "identifier": "8949261",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0242005",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "5307HA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I CRIME VICTIMS",
            "identifier": "8951177",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0248638",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "5309HA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "5308HA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "5305HA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS",
            "identifier": "8402620",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.