Individual provider Active NPI

Jarod Paul, DPT

  • Physical Therapist
  • Tulalip, WA
National Provider Identifier
1003584962
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61186581 Issued in WA
Practice address
7520 Totem Beach Rd
Tulalip, WA 98271-6160
Phone
(360) 716-4511
NPI assigned
Sep 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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 PT61186581 WA Primary

Addresses

Primary practice location

7520 Totem Beach Rd
Tulalip, WA 98271-6160

Mailing address

1060 Viola Rd
Viola, ID 83872-9607
Phone (208) 669-0816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211230000425 TX Practitioner - Physical Therapist in Private Practice 9537550512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tulalip Tribes of WashingtonGroup PAC ID 7719879782, 24 clinicians

Practice addresses (Care Compare)

7520 Totem Beach Rd
Tulalip, WA 98271-6160
Phone (360) 716-4511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT61186581WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tulalip Tribes of Washington CurrentSince Sep 22, 2021 Accepting new patients
Tulalip Tribes of Washington CurrentSince Sep 22, 2021 Accepting new patients
Tulalip Tribes of Washington Physical Therapist Current Accepting new patients

Locations

7520 Totem Beach Rd
Tulalip, WA 98271
Phone (360) 651-4511

6406 Marine Dr
Ste A
Tulalip, WA 98271

Organizations & group practices 3

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": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1003584962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 VIOLA RD",
            "city": "VIOLA",
            "state": "ID",
            "postal_code": "838729607",
            "telephone_number": "208-669-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7520 TOTEM BEACH RD",
            "city": "TULALIP",
            "state": "WA",
            "postal_code": "982716160",
            "telephone_number": "360-716-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "JAROD",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61186581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulalip, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.