Individual provider Active NPI

Jeffrey A Kriegel, PT

  • Physical Therapist
  • Everett, WA
National Provider Identifier
1215070149
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00008244 Issued in WA
Practice address
3726 Broadway
Suite 104
Everett, WA 98201-3787
Phone
(425) 252-4600
Fax
(425) 252-4477
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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 PT00008244 WA Primary

Addresses

Primary practice location

3726 Broadway
Suite 104
Everett, WA 98201-3787

Mailing address

10505 19TH Ave SE
Suite B
Everett, WA 98208-4280
Phone (877) 325-2776

Other identifiers 1

IdentifierTypeStateIssuer
8350951MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Rehabilitation PLLC Physical Therapist CurrentSince Apr 1, 2015 Accepting new patients
Cascade Rehabilitation Associates, PLLC Physical Therapist CurrentSince Jan 1, 2007 Accepting new patients
Cascade Rehabilitation Associates, PLLC Physical Therapist CurrentSince Jan 1, 2007 Accepting new patients
Summit Rehabilitation PLLC Physical Therapist CurrentSince Apr 1, 2015 Accepting new patients

Locations

10505 19th Ave SE
Ste B
Everett, WA 98208
Phone (408) 570-0510

3726 Broadway
Ste 104
Everett, WA 98201
Phone (425) 252-4600

10511 19th Ave SE
Ste B
Everett, WA 98208
Phone (425) 357-8885

9514 4th St NE
Unit 101
Lake Stevens, WA 98258
Phone (425) 397-2327

Organizations & group practices 4

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1215070149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10505 19TH AVE SE",
            "address_2": "SUITE B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084280",
            "telephone_number": "877-325-2776",
            "fax_number": "408-945-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3726 BROADWAY",
            "address_2": "SUITE 104",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013787",
            "telephone_number": "425-252-4600",
            "fax_number": "425-252-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIEGEL",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8350951",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.