Individual provider Active NPI

Tamara S Fiedler

  • Physical Therapist
  • Tumwater, WA
National Provider Identifier
1306994991
Registry record updated Aug 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00005664 Issued in WA
Practice address
4833 Tumwater Valley Dr SE Ste 150
Tumwater, WA 98501-4583
Phone
(360) 493-4160
NPI assigned
Jan 8, 2007
Last updated
Aug 6, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2009

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 PT00005664 WA Primary

Addresses

Primary practice location

4833 Tumwater Valley Dr SE Ste 150
Tumwater, WA 98501-4583

Mailing address

4833 Tumwater Valley Dr SE Ste 150
Tumwater, WA 98501-4583
Phone (360) 493-4160

Other identifiers 1

IdentifierTypeStateIssuer
PT00005664OtherWALICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250211003862 WA Practitioner - Physical Therapist in Private Practice 8729518386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penrose and Associates Physical Therapy LLCGroup PAC ID 1052403896, 11 clinicians

Practice addresses (Care Compare)

1445 Galaxy Dr NE
Suite 301
Lacey, WA 98516-4754
Phone (360) 456-1444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Penrose & Associates Physical Therapy LLC CurrentSince Feb 4, 2025 Accepting new patients
Providence Health & Services Washington Physical Therapist Past Accepting new patients
Centralia Physical Therapy Inc PS Physical Therapist PastSince Sep 8, 2025 Accepting new patients

Locations

1445 Galaxy Dr NE
Lacey, WA 98516
Phone (360) 456-1444

1445 Galaxy Dr NE
Ste 301
Lacey, WA 98516
Phone (360) 456-1444

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249516800000",
    "number": "1306994991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4833 TUMWATER VALLEY DR SE STE 150",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985014583",
            "telephone_number": "360-493-4160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4833 TUMWATER VALLEY DR SE STE 150",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985014583",
            "telephone_number": "360-493-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIEDLER",
        "first_name": "TAMARA",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2009-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00005664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PT00005664",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tumwater, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.