Benjamin Bloom
Individual provider Active NPI Physical Therapist · Lynwood, WA
NPI 1093676157 · NPPES record last updated Nov 19, 2025
Key facts
- NPI
- 1093676157
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT.PT.70037850 (WA)
- Practice address
- 17525 Pacific Hwy
Suite C
Lynwood, WA 98037 - Phone
- (425) 409-0218
- NPI assigned
- Nov 19, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Summit Rehabilitation PLLC
Practice addresses (Care Compare)
17525 Hwy 99
Suite C
Lynnwood, WA 98037-3105
Phone (425) 409-0218
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251210001709 | WA | Practitioner - Physical Therapist in Private Practice | 2163916834 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT.PT.70037850 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Rehabilitation PLLC | Physical Therapist | Current | Accepting new patients |
| Summit Rehabilitation PLLC | Current |
Accepting new patients | |
| Summit Rehabilitation PLLC | Physical Therapist | Current |
Accepting new patients |
Locations
9514 4th St NE
Unit 101
Lake Stevens, WA 98258
Phone (425) 397-2327
17525 Highway 99
Ste C
Lynnwood, WA 98037
Phone (206) 895-9620
12121 Harbour Reach Dr
Ste 100
Mukilteo, WA 98275
Phone (425) 354-5110
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT.PT.70037850 | WA | Yes |
Addresses
Primary practice location
17525 Pacific Hwy
Suite C
Lynwood, WA 98037
Mailing address
17120 15TH Ave NE Apt 201N
Shoreline, WA 98155-5139
Other providers in Lynwood, WA
- Hanen Alyasiri
- Robin J Atkinson
- Bembenek Travel Health Washington, PC
- City of Lynnwood
- Nicole Marie Conlon
- Amy May Derksen
- Evergreen Recovery Centers-Health Services
- Hidayet Taha Karapinar
All providers in Lynwood, WA · Physical Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.