Individual provider Active NPI

Priyanka Gupta, PT

  • Physical Therapist
  • Bellevue, WA
National Provider Identifier
1295989036
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60028820 Issued in WA
Practice address
12951 Bel Red Rd
Suite100
Bellevue, WA 98005-2644
Phone
(425) 435-5277
Fax
(425) 455-2910
NPI assigned
Nov 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2015

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 PT60028820 WA Primary

Addresses

Primary practice location

12951 Bel Red Rd
Suite100
Bellevue, WA 98005-2644

Mailing address

12951 Bel Red Rd
Suite100
Bellevue, WA 98005-2644
Phone (425) 435-5277

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150630001885 WA Practitioner - Physical Therapist in Private Practice 4981916152 Receives reassigned benefits from 4 practitioners
Practice locations: Bellevue, WA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14715 NE Bel Red Rd
Suite 100
Bellevue, WA 98007-3940
Phone (425) 435-5277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60028820WAMDPhysical Therapist

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1295989036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12951 BEL RED RD",
            "address_2": "SUITE100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052644",
            "telephone_number": "425-435-5277",
            "fax_number": "425-455-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12951 BEL RED RD",
            "address_2": "SUITE100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052644",
            "telephone_number": "425-435-5277",
            "fax_number": "425-455-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "PRIYANKA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60028820",
            "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 Mar 9, 2015; 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.