Individual provider Active NPI

Brent Arthur Wong, DPT

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1235703463
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61155889 Issued in WA
Practice address
5620 Rainier Ave S Ste 102
Seattle, WA 98118-2498
Phone
(206) 535-8061
NPI assigned
May 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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 PT61155889 WA Primary

Addresses

Primary practice location

5620 Rainier Ave S Ste 102
Seattle, WA 98118-2498

Mailing address

911 233Rd PL SW
Bothell, WA 98021-7314

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210907001299 WA Practitioner - Physical Therapist in Private Practice 5092111641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back to Work Prevention and Physical Therapy IncGroup PAC ID 0446444624, 26 clinicians

Practice addresses (Care Compare)

5620 Rainier Ave S
Suite 102
Seattle, WA 98118-2498
Phone (206) 535-8061

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Back to Work Prevention & Physical Therapy, Inc. CurrentSince Jul 12, 2021 Accepting new patients

Locations

5620 Rainier Ave S
Ste 102
Seattle, WA 98118
Phone (206) 535-8061

Organizations & group practices 1

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": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1235703463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 233RD PL SW",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980217314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 RAINIER AVE S STE 102",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981182498",
            "telephone_number": "206-535-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "BRENT",
        "middle_name": "ARTHUR",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61155889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; 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.