Individual provider Active NPI

John Paul Maisano, P.T.

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1124171947
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00000574 Issued in WA
Practice address
200 15TH Ave E
Seattle, WA 98112-5260
Phone
(206) 326-3000
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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 PT00000574 WA Primary

Addresses

Primary practice location

200 15TH Ave E
Seattle, WA 98112-5260

Mailing address

201 16TH Ave E
Group Health PT Depart
Seattle, WA 98112-5260
Phone (206) 326-2747

Other identifiers 1

IdentifierTypeStateIssuer
8413999MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120126000460 WA Practitioner - Physical Therapist in Private Practice 4486821782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

201 16TH Ave E
Seattle, WA 98112-5226
Phone (206) 326-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00000574WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Dec 29, 2013 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Dec 29, 2013 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients

Locations

2930 Maple St
Everett, WA 98201
Phone (425) 261-1500

3030 Limited Ln NW
Olympia, WA 98502
Phone (360) 352-6000

201 16th Ave E
Seattle, WA 98112
Phone (206) 326-4545

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

939 Mountain View Dr
Ste 100
Shelton, WA 98584
Phone (360) 426-2653

10452 Silverdale Way NW
Silverdale, WA 98383
Phone (360) 307-7300

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

5821 S Sprague Ct
Tacoma, WA 98409
Phone (253) 396-4200

Interoperability endpoints

  • Direct secure messaging: jmaisanotorres34309@ghc.direct-ci.net

Organizations & group practices 3

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1124171947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 16TH AVE E",
            "address_2": "GROUP HEALTH PT DEPART",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981125260",
            "telephone_number": "206-326-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 15TH AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981125260",
            "telephone_number": "206-326-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAISANO",
        "first_name": "JOHN",
        "middle_name": "PAUL",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00000574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8413999",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "200 15th Ave E",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981125260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.