Individual provider Active NPI

Ryan Heilman, DPT

  • Physical Therapist
  • Eagle, ID
National Provider Identifier
1043895600
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4571562 Issued in ID
Practice address
457 S Fitness PL Ste 100
Eagle, ID 83616-6568
Phone
(208) 939-3332
Fax
(208) 939-3338
NPI assigned
Mar 16, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT61138871 WA
Physical Therapist 225100000X 4571562 ID Primary

Addresses

Primary practice location

457 S Fitness PL Ste 100
Eagle, ID 83616-6568

Mailing address

457 S Fitness PL Ste 100
Eagle, ID 83616-6568
Phone (208) 939-3332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210324000000 WA Practitioner - Physical Therapist in Private Practice 9133536972 Reassigns benefits to 1 organization
I20251001002354 ID Practitioner - Physical Therapist in Private Practice 9133536972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Miami, LM Miller School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eagle Physical Therapy PAGroup PAC ID 7719967744, 7 clinicians

Practice addresses (Care Compare)

457 S Fitness PL
Suite 100
Eagle, ID 83616-6568
Phone (208) 939-3332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4571562IDMDPhysical Therapist
PT61138871WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Mar 9, 2021 Accepting new patients
Eagle Physical Therapy PA Physical Therapist CurrentSince Sep 8, 2025 Accepting new patients
Multicare Health System Physical Therapist CurrentSince Mar 9, 2021 Accepting new patients

Locations

457 S Fitness Pl
Ste 100
Eagle, ID 83616
Phone (208) 939-3332

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

1450 5th St SE
Ste 4400
Puyallup, WA 98372
Phone (253) 697-2340

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": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1043895600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 S FITNESS PL STE 100",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166568",
            "telephone_number": "208-939-3332",
            "fax_number": "208-939-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 S FITNESS PL STE 100",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166568",
            "telephone_number": "208-939-3332",
            "fax_number": "208-939-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEILMAN",
        "first_name": "RYAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-16",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61138871",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "4571562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; 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.