Individual provider Active NPI

Benjamin Benjamin Wobker, MS PT

  • Physical Therapist
  • Redmond, WA
National Provider Identifier
1083772388
Registry record updated Mar 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00008352 Issued in WA
Practice address
8495 161 Ave NE
Redmond, WA 98052
Phone
(425) 881-3001
Fax
(475) 881-3585
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2020

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 PT00008352 WA Primary

Addresses

Primary practice location

8495 161 Ave NE
Redmond, WA 98052

Mailing address

209 Kirkland Ave
Kirkland, WA 98033-6503
Phone (425) 629-3502

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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Redmond Physical Therapy, Inc. Physical Therapist PastSince Nov 1, 2010 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584748800000",
    "number": "1083772388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 KIRKLAND AVE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336503",
            "telephone_number": "425-629-3502",
            "fax_number": "425-629-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8495 161 AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "98052",
            "telephone_number": "425-881-3001",
            "fax_number": "475-881-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOBKER",
        "first_name": "BENJAMIN",
        "middle_name": "BENJAMIN",
        "credential": "MS PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-03-21",
        "certification_date": "2020-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2020; 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.