Individual provider Active NPI

Heidi Kodeski, PT

  • Physical Therapist
  • Bellevue, WA
National Provider Identifier
1225102700
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT8731 Issued in WA
Practice address
1601 116TH Ave NE
Suite 101
Bellevue, WA 98004-3010
Phone
(425) 881-3100
Fax
(425) 881-3102
NPI assigned
Nov 17, 2006
Sex
Female
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 PT8731 WA Primary

Addresses

Primary practice location

1601 116TH Ave NE
Suite 101
Bellevue, WA 98004-3010

Mailing address

1601 116TH Ave NE
Suite 101
Bellevue, WA 98004-3010
Phone (425) 881-3100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040907000470 WA Practitioner - Physical Therapist in Private Practice 0941276414 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

284 Central Way
Kirkland, WA 98033-6104
Phone (206) 565-6472

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT8731WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Performance and Therapy CurrentSince Apr 20, 2016 Accepting new patients
Epic PT Health & Performance LLC Physical Therapist CurrentSince Dec 15, 2014 Accepting new patients
Redmond Spine Center, PLLC Physical Therapist Past Accepting new patients
Integrated Health PLLC Past Accepting new patients
Engineered Sports 2 PLLC Physical Therapist PastSince Dec 6, 2020 Accepting new patients
Washington Physical Therapy and Rehabilitation LLC Physical Therapist PastSince Dec 15, 2019 Accepting new patients

Locations

13353 NE Bel Red Rd
Ste 103
Bellevue, WA 98005
Phone (425) 679-5996

284 Central Way
Kirkland, WA 98033
Phone (206) 565-6472

5006 Center St
Ste N
Tacoma, WA 98409
Phone (253) 476-0449

Organizations & group practices 6

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225102700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 116TH AVE NE",
            "address_2": "SUITE 101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043010",
            "telephone_number": "425-881-3100",
            "fax_number": "425-881-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 116TH AVE NE",
            "address_2": "SUITE 101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043010",
            "telephone_number": "425-881-3100",
            "fax_number": "425-881-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODESKI",
        "first_name": "HEIDI",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT8731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, 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.