Douglas A Houle, MSPT
Individual provider Active NPI Physical Therapist · Moscow, ID
NPI 1174584288 · NPPES record last updated Aug 28, 2023
Key facts
- NPI
- 1174584288
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 7465 (CO)
- Practice address
- 2009 S Main St
Moscow, ID 83843-8913 - Phone
- (208) 882-1426
- NPI assigned
- Mar 29, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- BK Inc.
Practice addresses (Care Compare)
2009 S Main St
Moscow, ID 83843-8913
Phone (208) 618-8430
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230915003222 | ID | Practitioner - Physical Therapist in Private Practice | 9335113679 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7465 | CO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BK Inc. | Current |
Accepting new patients | |
| Select Physical Therapy of Colorado Springs LP | Past | Accepting new patients | |
| MVP Physical Therapy, LLC | Physical Therapist | Past |
Accepting new patients |
| Select Physical Therapy Holdings Inc | Physical Therapist | Past | Accepting new patients |
| Select Physical Therapy Holdings Inc | Past | Accepting new patients | |
| Select Physical Therapy of Colorado Springs LP | Past |
Accepting new patients |
Locations
2009 S Main St
Moscow, ID 83843
Phone (208) 618-8430
904 White Ave
Moscow, ID 83843
Phone (208) 596-1056
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7465 | CO | Yes |
Addresses
Primary practice location
2009 S Main St
Moscow, ID 83843-8913
Mailing address
2009 S Main St
Moscow, ID 83843-8913
Phone (208) 882-1426
Other practice location 1
904 White Ave
Moscow, ID 83843-3932
Phone (208) 882-1426
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48206849 | Medicaid | CO |
Other providers in Moscow, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2023. 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.