Excel Performance Health and Wellness, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

EXCEL PERFORMANCE HEALTH AND WELLNESS, LLC

Practice address

100 Palisades PL
Pacific, WA 98047-5003

Phone

(646) 982-7585

NPI assigned

Jul 16, 2024

Last updated

Jul 16, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angelito Mabini, MPTNPI 1083880561

Title

Manager

Phone

(253) 988-4116

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angelito Ancheta Mabini, MSPT

  • Physical Therapist
  • University Place, WA
  • NPI 1083880561
  Medicare reassignment NPD Authorized official
• Richard Lau

  • Physical Therapy Assistant
  • Auburn, WA
  • NPI 1013651587
  NPD

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1215775275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PALISADES PL",
            "city": "PACIFIC",
            "state": "WA",
            "postal_code": "980475003",
            "telephone_number": "646-982-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PALISADES PL",
            "city": "PACIFIC",
            "state": "WA",
            "postal_code": "980475003",
            "telephone_number": "646-982-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL PERFORMANCE HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "MABINI",
        "authorized_official_first_name": "ANGELITO",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "253-988-4116",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Obalvanna CHI
• Dalya Dawood
• Suzan Marie-Jon Douglass, LMT
• Ligia Dufour
• Sarah Danielle Dwyer, LMT
• Kiley K Gallentine, PSYD
• Alexis Gonzalez
• Judy H Jansen, LMP
• Jere' L. Slingerland, LCSW.Inc
• Yelena Kravchenko, PTA

• Physical Therapist in Pacific, WA
• Providers in Pacific, 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 16, 2024; 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.