NPIMap

Organization Active NPI

Therapeutic Associates Inc

Doing business as Therapeutic Associates

  • Physical Therapist
  • Eagle, ID
National Provider Identifier
1144636358
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
THERAPEUTIC ASSOCIATES INC
Doing business as
Therapeutic Associates
Practice address
12 N Fisher Park Way
Ste. 100
Eagle, ID 83616-4704
Phone
(208) 939-0140
Fax
(208) 939-0139
NPI assigned
Jul 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Authorized official

Name
Melissa Hamilton
Title
Dir Payer & Provider Relations
Phone
(503) 443-6156

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

12 N Fisher Park Way
Ste. 100
Eagle, ID 83616-4704

Mailing address

16083 SW Upper Boones Ferry Rd
Ste. 300
Tigard, OR 97224-7736
Phone (800) 219-8835

Other identifiers 2

IdentifierTypeStateIssuer
0330314OtherIDWA L&I
1144636358MedicaidID

Other names 1

  • Therapeutic Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040515000415 ID Part B Supplier - Clinic/Group Practice 0042116279 Receives reassigned benefits from 34 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boise, ID; Nampa, ID; Meridian, ID; Eagle, ID

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Sally J Miller PT100 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 6

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

2635 Caldwell Blvd
#B
Nampa, ID 83651
Phone (208) 442-0577

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684800000000",
    "number": "1144636358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD",
            "address_2": "STE. 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "800-219-8835",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N FISHER PARK WAY",
            "address_2": "STE. 100",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836164704",
            "telephone_number": "208-939-0140",
            "fax_number": "208-939-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-08",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "DIR PAYER & PROVIDER RELATIONS",
        "authorized_official_telephone_number": "503-443-6156"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L&I",
            "identifier": "0330314",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144636358",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Therapeutic Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Therapeutic Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagle, ID

Sources for this page

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