Daniel W Roberts, P.T.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT00002482 Issued in WA

Practice address

707 S Park St
Deer Park, WA 99006-0948

Phone

(509) 276-8811

Fax

(866) 629-4801

NPI assigned

May 27, 2005

Last updated

Jun 26, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Loma Linda University School of Medicine, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Deer Park Physical Therapy IncGroup PAC ID 6103716840, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Deer Park Physical Therapy Inc

  • Physical Therapist
  • Deer Park, WA
  • NPI 1306903182
  Medicare reassignment Care Compare group NPD Authorized official
• Revive Therapeutic Massage

  • Massage Therapist
  • Deer Park, WA
  • NPI 1427766328
  NPD (past)

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1295738813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S PARK ST",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "990060948",
            "telephone_number": "509-276-8811",
            "fax_number": "866-629-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S PARK ST",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "990060948",
            "telephone_number": "509-276-8811",
            "fax_number": "866-629-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "DANIEL",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WA",
            "license": "PT00002482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8334120",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Lynn Puthoff
• Stephanie Quackenbush, COTA/L
• Revive Therapeutic Massage
• Taryn Marie Ridley, DPT
• Andrew S Roberts, DPT
• Rockwood Clinic PS (Rockwood Deer Park)
• Selina Marie Ross, ARNP
• Corinna Renee Rozelle, PTA
• Shelby Renae Rush, MD
• Ryan L Bates DDS PS

• Orthopedic Physical Therapist in Deer Park, WA
• Providers in Deer Park, WA by specialty
• Orthopedic Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.