NPIMap

Organization Active NPI

Summit Rehabilitation PLLC

Doing business as Summit Rehabilitation

  • Physical Therapy Clinic/Center
  • Lake Stevens, WA
National Provider Identifier
1013648153
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SUMMIT REHABILITATION PLLC
Doing business as
Summit Rehabilitation
Practice address
9514 4TH St NE Unit 101
Lake Stevens, WA 98258-1937
Phone
(206) 257-1514
Fax
(206) 743-9143
NPI assigned
Jun 20, 2022
Last updated
Jun 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Authorized official

Name
Robert PaceNPI 1164643466
Title
Owner
Phone
(213) 804-1712

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

9514 4TH St NE Unit 101
Lake Stevens, WA 98258-1937

Mailing address

2035 Corte del Nogal Ste 200
Carlsbad, CA 92011-1445
Phone (760) 931-8310

Other names 1

  • Summit Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040203000556 WA Part B Supplier - Clinic/Group Practice 9133012362 Receives reassigned benefits from 99 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Snohomish, WA; Sultan, WA; Redmond, WA; Mukilteo, WA; Mill Creek, WA; Lynnwood, WA; Lake Stevens, WA; Kirkland, WA…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Summit Rehabilitation PLLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10511 19th Ave SE
Ste B
Everett, WA 98208
Phone (425) 357-8885

12121 Harbour Reach Dr
Ste 100
Mukilteo, WA 98275
Phone (425) 354-5110

17223 Avondale Way NE
Redmond, WA 98052
Phone (425) 403-0232

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655683200000",
    "number": "1013648153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 CORTE DEL NOGAL STE 200",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111445",
            "telephone_number": "760-931-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9514 4TH ST NE UNIT 101",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982581937",
            "telephone_number": "206-257-1514",
            "fax_number": "206-743-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT REHABILITATION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-804-1712"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Stevens, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.