Individual provider Active NPI

Garrett T Yamada, PT

  • Physical Therapist
  • Puyallup, WA
National Provider Identifier
1225063043
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00010173 Issued in WA
Practice address
8011 112TH Street CT E
Puyallup, WA 98373-7814
Phone
(253) 848-0662
Fax
(253) 848-8567
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT00010173 WA Primary

Addresses

Primary practice location

8011 112TH Street CT E
Puyallup, WA 98373-7814

Mailing address

9315 Gravelly Lake Dr SW
Suite 203
Lakewood, WA 98499-1574
Phone (253) 581-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091124000406 HI Practitioner - Physical Therapist in Private Practice 3476556127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Physical Therapy and SportsGroup PAC ID 6709890429, 4 clinicians

Practice addresses (Care Compare)

1043 Makawad Ave
Suite 107
Makawao, HI 96768
Phone (808) 572-7790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
PT00010173WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Physical Therapy and Sports Physical Therapist CurrentSince Jul 1, 2009 Accepting new patients
Olympic Sports and Spine Rehabilitation PS Physical Therapist Past Accepting new patients
Community Clinic of Maui, Inc. Past Accepting new patients

Locations

1043 Makawao Ave
Ste 107
Makawao, HI 96768
Phone (808) 572-7790

6 Central Ave
Wailuku, HI 96793
Phone (808) 244-5541

Organizations & group practices 3

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225063043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9315 GRAVELLY LAKE DR SW",
            "address_2": "SUITE 203",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991574",
            "telephone_number": "253-581-5200",
            "fax_number": "253-581-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8011 112TH STREET CT E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983737814",
            "telephone_number": "253-848-0662",
            "fax_number": "253-848-8567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMADA",
        "first_name": "GARRETT",
        "middle_name": "T",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00010173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.