Tyler Zachery Ma, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT61446427 Issued in WA

Practice address

4030 Alderwood Mall Blvd
Lynnwood, WA 98036-6763

Phone

(425) 776-0803

NPI assigned

Jul 14, 2023

Last updated

Jul 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emerald City Physical Therapy SVCS LLCGroup PAC ID 0547442469, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emerald City Physical Therapy SVCS, LLC

  dba Salmon Bay Physical Therapy

  • Physical Medicine & Rehabilitation Physician
  • Seattle, WA
  • NPI 1881998482
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1184303273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3652 252ND PL SE",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980297758",
            "telephone_number": "425-233-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 ALDERWOOD MALL BLVD",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366763",
            "telephone_number": "425-776-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MA",
        "first_name": "TYLER",
        "middle_name": "ZACHERY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-14",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61446427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynnwood SNF Operations LLC (Alderwood Post Acute & Rehabilitation)
• Lynnwood Speech & Language Services (Susan E. Stewart)
• Lynnwoodsmiles
• M Jay Campbell D C P S
• M&a Adult Family Home LLC
• Mabuhay Medical Supply and Equipment
• Marie Choquette Maccoy, LICSW, CDP, CMHS, MH
• Steven Masuo Machida, D.D.S.
• Veronica Prajedez Macias
• Madison Kalen Macintosh

• Physical Therapist in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; 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.