Individual provider Active NPI

Ishwari Sanjay Upasani

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1174016174
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60571830 Issued in WA
Practice address
3221 Eastlake Ave E Ste 110
Seattle, WA 98102-7125
Phone
(206) 405-1864
NPI assigned
Jun 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2018

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 PT60571830 WA Primary

Addresses

Primary practice location

3221 Eastlake Ave E Ste 110
Seattle, WA 98102-7125

Mailing address

807 3Rd Ave N Apt 24
Seattle, WA 98109-3771
Phone (352) 410-2045

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180713001972 WA Practitioner - Physical Therapist in Private Practice 8224384714 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60571830WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emerald City Physical Therapy SVCS, LLC CurrentSince Apr 15, 2019 Accepting new patients

Locations

6500 6th Ave NW
Ste A
Seattle, WA 98117
Phone (206) 775-9995

1455 NW Leary Way
Ste 150
Seattle, WA 98107
Phone (206) 284-9088

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": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1174016174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 3RD AVE N APT 24",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981093771",
            "telephone_number": "352-410-2045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3221 EASTLAKE AVE E STE 110",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981027125",
            "telephone_number": "206-405-1864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPASANI",
        "first_name": "ISHWARI",
        "middle_name": "SANJAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60571830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jun 13, 2018; 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.