Active NPI
Mimi Colette Malgarini, P.T.
- Physical Therapist
- Silverdale, WA
National Provider Identifier
1013962208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00006454
- Practice address
- 4409 NW Anderson Hill Rd
Silverdale, WA 98383-6807 - Phone
- (360) 698-6630
- Fax
- (360) 698-7002
- NPI assigned
- May 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00006454 | WA | Primary |
Addresses
Primary practice location
4409 NW Anderson Hill Rd
Silverdale, WA 98383-6807
Mailing address
PO Box 450
Silverdale, WA 98383-0450
Phone (360) 698-6630
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 810588134-02 | Other | WA | KPS HEALTH PLANS |
| 0162547 | Other | WA | DEPT OF LABOR & INDUSTRIE |
| 0279230 | Other | WA | LABOR AND INDRUSTRIES |
| 9119MA | Other | WA | REGENCE BLUE SHIELD |
| 5161656 | Other | WA | AETNA/LEXINGTON, KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00006454 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Motion Physical Therapy, Inc., PS | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Bainbridge Island, WA
- NPI 1578518668
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395792000000",
"number": "1013962208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 450",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "983830450",
"telephone_number": "360-698-6630",
"fax_number": "360-698-7002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4409 NW ANDERSON HILL RD",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "983836807",
"telephone_number": "360-698-6630",
"fax_number": "360-698-7002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALGARINI",
"first_name": "MIMI",
"middle_name": "COLETTE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-24",
"last_updated": "2014-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00006454",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KPS HEALTH PLANS",
"identifier": "810588134-02",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR & INDUSTRIE",
"identifier": "0162547",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDRUSTRIES",
"identifier": "0279230",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "9119MA",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/LEXINGTON, KY",
"identifier": "5161656",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Silverdale, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.