Andrew B Stephens, PT, ATC
Individual provider Active NPI Physical Therapist · Eastsound, WA
NPI 1205855962 · NPPES record last updated Mar 29, 2017
Key facts
- NPI
- 1205855962
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 00007789 (WA)
- Practice address
- 49 Deye Lane
Eastsound, WA 98245 - Phone
- (360) 376-6604
- Fax
- (360) 376-4059
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Orcas Island Physical Therapy PLLC
Practice addresses (Care Compare)
49 Deye LN
Eastsound, WA 98245-8578
Phone (360) 376-6604
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040427000212 | WA | Practitioner - Physical Therapist in Private Practice | 7113914995 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00007789 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orcas Island Physical Therapy, PLLC | Physical Therapist | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 00007789 | WA | Yes |
Addresses
Primary practice location
49 Deye Lane
Eastsound, WA 98245
Mailing address
PO Box 487
Eastsound, WA 98245
Phone (360) 376-6604
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7123748 | Medicaid | WA |
Other providers in Eastsound, WA
- Shorewood Communications Inc
- Sasheem Silkiss-Hero
- Jennifer Lynn Simpson-Manske
- Beth Ann Smith
- Alyson C. Stephens
- Patrick Stockstill
- Maryann Syers
- The Counseling Collective
- The Counseling Collective
- Katharina Torri
All providers in Eastsound, WA · Physical Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2017. 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.