Individual provider Active NPI

Melissa Jennings Fabry Thomas, DPT

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1043643422
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60369831 Issued in WA
Practice address
728 N 79TH St
Seattle, WA 98103-4712
Phone
(206) 696-4383
NPI assigned
Aug 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 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 PT60369831 WA Primary

Addresses

Primary practice location

728 N 79TH St
Seattle, WA 98103-4712

Mailing address

728 N 79TH St
Seattle, WA 98103-4712
Phone (206) 696-4383

Other identifiers 3

IdentifierTypeStateIssuer
P01276059OtherWAMEDICARE RAILROAD
0316275OtherWADEPT. OF LABOR AND INDUSTRIES
1043643422MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131114000618 WA Practitioner - Physical Therapist in Private Practice 8224264593 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12040 NE 128TH St
Ms 10
Kirkland, WA 98034-3013
Phone (206) 466-0369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60369831WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Physical Therapist CurrentSince Apr 26, 2023 Accepting new patients
King County Public Hospital District No. 2 Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients
Swedish Health Services CurrentSince Apr 26, 2023 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Washington Luna Care Physical Therapy LLC Physical Therapist CurrentSince May 5, 2020 Accepting new patients

Locations

13555 SE 36th St
Ste 100
Bellevue, WA 98006

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

12040 NE 128th St
#10
Kirkland, WA 98034
Phone (206) 466-0369

800 5th Ave
Ste P100
Seattle, WA 98104
Phone (206) 320-2700

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

Organizations & group practices 5

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": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1043643422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 N 79TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981034712",
            "telephone_number": "206-696-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 N 79TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981034712",
            "telephone_number": "206-696-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MELISSA",
        "middle_name": "JENNINGS FABRY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60369831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01276059",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF LABOR AND INDUSTRIES",
            "identifier": "0316275",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043643422",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.