NPIMap

Organization Active NPI

Highline Physical Therapy Group

  • Physical Therapist
  • Bonney Lake, WA
National Provider Identifier
1255147336
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
HIGHLINE PHYSICAL THERAPY GROUP
Practice address
20910 State Route 410 E
Bonney Lake, WA 98391-6302
Phone
(253) 862-2575
Fax
(253) 862-2675
NPI assigned
Dec 4, 2024
Last updated
Dec 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Authorized official

Name
Robert PaceNPI 1164643466
Title
Coo
Phone
(213) 804-1712

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

20910 State Route 410 E
Bonney Lake, WA 98391-6302

Mailing address

2600 Dallas Pkwy Ste 290
Frisco, TX 75034-7493
Phone (945) 260-0010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250206003090 WA DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 8820172984 Practice locations: Bonney Lake, WA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Highline Physical Therapy Group5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1010 S 336th St
Ste 112
Federal Way, WA 98003
Phone (253) 466-6017

1615 S 325th St
Federal Way, WA 98003
Phone (253) 661-0041

1416 NW 46th St
Seattle, WA 98107
Phone (206) 677-9760

4744 41st Ave SW
Seattle, WA 98116
Phone (206) 933-1030

4744 41st Ave SW
Ste 105
Seattle, WA 98116
Phone (206) 933-1030

1215 N McDonald Rd
Ste 102
Spokane Valley, WA 99216
Phone (509) 319-2029

Practitioners & affiliated clinicians

Practitioners 126

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.

View all 126

NPI Registry JSON

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

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1255147336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 DALLAS PKWY STE 290",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750347493",
            "telephone_number": "945-260-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20910 STATE ROUTE 410 E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916302",
            "telephone_number": "253-862-2575",
            "fax_number": "253-862-2675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLINE PHYSICAL THERAPY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "213-804-1712"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.