Individual provider Active NPI

Samantha L. Gubka, DPT, OCS, CCCE

  • Physical Therapist
  • Lakewood, WA
National Provider Identifier
1023104130
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00010284 Issued in WA
Practice address
7308 Bridgeport Way W
Suite 103
Lakewood, WA 98499-8000
Phone
(253) 582-8142
Fax
(253) 582-8160
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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 PT00010284 WA Primary

Addresses

Primary practice location

7308 Bridgeport Way W
Suite 103
Lakewood, WA 98499-8000

Mailing address

4040 Orchard St W
Suite 100
Fircrest, WA 98466-6606
Phone (253) 564-1560

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061229000280 WA Practitioner - Physical Therapist in Private Practice 2365442175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

202 Cross St SE
Auburn, WA 98002-5406
Phone (253) 876-8190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Dec 10, 2018 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System Physical Therapist CurrentSince Dec 10, 2018 Accepting new patients
Multicare Health System Physical Therapist Past Accepting new patients

Locations

202 Cross St SE
Auburn, WA 98002
Phone (253) 680-6000

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

3209 S 23rd St
Ste 100
Tacoma, WA 98405
Phone (253) 459-6999

Organizations & group practices 4

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1023104130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 ORCHARD ST W",
            "address_2": "SUITE 100",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666606",
            "telephone_number": "253-564-1560",
            "fax_number": "253-564-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7308 BRIDGEPORT WAY W",
            "address_2": "SUITE 103",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998000",
            "telephone_number": "253-582-8142",
            "fax_number": "253-582-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUBKA",
        "first_name": "SAMANTHA",
        "middle_name": "L.",
        "credential": "DPT, OCS, CCCE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00010284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.