Individual provider Active NPI

Robert E Tutland, RPT

  • Physical Therapist
  • Bellevue, WA
National Provider Identifier
1073687729
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00000870 Issued in WA
Practice address
11711 NE 12TH St
Ste 3a
Bellevue, WA 98005-2461
Phone
(425) 450-9474
Fax
(425) 635-9340
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT00000870 WA Primary

Addresses

Primary practice location

11711 NE 12TH St
Ste 3a
Bellevue, WA 98005-2461

Mailing address

11711 NE 12TH St
Ste 3a
Bellevue, WA 98005-2461
Phone (425) 450-9474

Other identifiers 2

IdentifierTypeStateIssuer
785190MedicaidWA
33890OtherWKRS COMP

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

LicenseStateTypeSpecialty
PT00000870WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Management Services, PLLC Physical Therapist PastSince Oct 10, 2013 Accepting new patients
Therapy Management Services, PLLC Physical Therapist PastSince Feb 20, 2015 Accepting new patients
TMB Partnership Physical Therapist PastSince Jun 1, 2005 Accepting new patients
Palm Desert Physical Therapy, Inc. Physical Therapist PastSince Aug 6, 2003 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073687729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11711 NE 12TH ST",
            "address_2": "STE 3A",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052461",
            "telephone_number": "425-450-9474",
            "fax_number": "425-635-9340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11711 NE 12TH ST",
            "address_2": "STE 3A",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052461",
            "telephone_number": "425-450-9474",
            "fax_number": "425-635-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTLAND",
        "first_name": "ROBERT",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00000870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "785190",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WKRS COMP",
            "identifier": "33890",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.