Jordan Agtarap

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

5765 Littlerock Rd SW Ste 107
Tumwater, WA 98512-7311

Phone

(564) 999-4146

NPI assigned

Oct 7, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prevail Practices PLLCGroup PAC ID 2163781634, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Prevail Practices, PLLC

  • Physical Therapist
  • Shoreline, WA
  • NPI 1740723915
  Medicare reassignment Care Compare group NPD
• Integrated Rehabilitation Group, PC

  • Physical Therapy Clinic/Center
  • Mill Creek, WA
  • NPI 1154369833

  Physical Therapist, WA

  Medicare reassignment NPD
• Northwest Center for Sports Medicine & Physical Therapy, Inc.

  • Physical Therapist
  • Gig Harbor, WA
  • NPI 1982755070
  Medicare reassignment NPD
• Integrated Rehabilitation Group, PC

  • Physical Therapy Clinic/Center
  • Marysville, WA
  • NPI 1215201801

  Physical Therapist

  NPD
• Northwest Center for Sports Medicine & Physical Therapy Inc

  • Physical Therapist
  • Tumwater, WA
  • NPI 1922652262
  NPD
• Northwest Center for Sports Medicine & Physical Therapy, Inc.

  • Physical Therapist
  • Tacoma, WA
  • NPI 1225582844
  NPD (past)

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1003578063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-682-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5765 LITTLEROCK RD SW STE 107",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985127311",
            "telephone_number": "564-999-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGTARAP",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Michael Adkinson
• Advanced Iom Specialists
• Advanced Pharmacy Solutions, LLC
• Taiwo Agabi
• Kaitlin Joyce Agosta, BCBA
• Andres Federico Aguirre, MS
• Jessica Bruce Ahern, ARNP
• McKenzie James Airhart, CDPT
• Ajaipal Dhanoa PLLC
• Albertsons LLC

• All providers in Tumwater, WA
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.