NPIMap

Organization Active NPI

Proliance Surgeons, Inc., P.S.

  • Hand Occupational Therapist
  • Bellevue, WA
National Provider Identifier
1104474808
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
Legal business name
PROLIANCE SURGEONS, INC., P.S.
Practice address
3101 Northup Way Ste 301
Bellevue, WA 98004-1449
Phone
(425) 462-5006
Fax
(425) 462-5019
NPI assigned
Aug 27, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Authorized official

Name
Cori M. Pleasant
Title
Credentialing & Enrollment Manager
Phone
(206) 838-2585

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225XH1200X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

3101 Northup Way Ste 301
Bellevue, WA 98004-1449

Mailing address

510 8TH Ave NE Ste 320
Issaquah, WA 98029-5436
Phone (425) 507-0733

Other names 1

  • Proliance Sports Therapy and Rehab of Bellevue Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191010000621 WA DME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Independently-Practicing Physical Therapist 8527972900 Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory
Tax ID family
Orthopedic Physicians46 organizations share this tax ID, including this one

Other organizations with this tax ID 45

Organizations that report the same tax identification number in the National Provider Directory.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679529600000",
    "number": "1104474808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 320",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295436",
            "telephone_number": "425-507-0733",
            "fax_number": "425-283-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 NORTHUP WAY STE 301",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980041449",
            "telephone_number": "425-462-5006",
            "fax_number": "425-462-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-27",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "PLEASANT",
        "authorized_official_first_name": "CORI",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CREDENTIALING & ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "206-838-2585"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proliance Sports Therapy and Rehab of Bellevue",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proliance Sports Therapy and Rehab of Bellevue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.