Active NPI
Mark L. Leek, P.T.
- Physical Therapist
- Everett, WA
National Provider Identifier
1326162439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00010397
- Practice address
- 3927 Rucker Ave
Everett, WA 98201-4833 - Phone
- (360) 454-1900
- Fax
- (360) 454-1991
- NPI assigned
- Mar 16, 2007
- Last updated
- Mar 15, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | PT00010397 | WA | |
| Physical Therapist | 225100000X | PT00010397 | WA | Primary |
Addresses
Primary practice location
3927 Rucker Ave
Everett, WA 98201-4833
Mailing address
PO Box 5127
Everett, WA 98206-5127
Phone (360) 454-1900
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8494783 | Other | WA | DSHS |
| 0229756 | Other | WA | L&I |
| 3388LE | Other | WA | REGENCE BS |
| 5677LE | Other | WA | REGENCE BS |
| 8871179 | Other | WA | MEDICARE |
| 8946493 | Other | WA | L&I CRIME |
| 0229758 | Other | WA | L&I |
| 3347LE | Other | WA | REGENCE BS |
| 7661LE | Other | WA | REGENCE BS |
| P00739007 | Other | WA | RAILROAD MEDICARE |
| 1043745 | Medicaid | WA | |
| 8871180 | Other | WA | MEDICARE |
| 9411LE | Other | WA | REGENCE BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00010397 | WA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Performax, LLC | Past | Accepting new patients | |
| Integrated Rehabilitation Group, PC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba IRG Physical & Hand Therapy - Marysville
- Physical Therapy Clinic/Center
- Marysville, WA
- NPI 1215201801
Physical Therapist
-
dba FYZICAL Therapy & Balance Centers
- Orthopedic Physical Therapist
- Bothell, WA
- NPI 1538276407
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489536000000",
"number": "1326162439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5127",
"city": "EVERETT",
"state": "WA",
"postal_code": "982065127",
"telephone_number": "360-454-1900",
"fax_number": "360-454-1991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3927 RUCKER AVE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014833",
"telephone_number": "360-454-1900",
"fax_number": "360-454-1991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEEK",
"first_name": "MARK",
"middle_name": "L.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2017-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "PT00010397",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00010397",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DSHS",
"identifier": "8494783",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "0229756",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BS",
"identifier": "3388LE",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BS",
"identifier": "5677LE",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "8871179",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I CRIME",
"identifier": "8946493",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "0229758",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BS",
"identifier": "3347LE",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BS",
"identifier": "7661LE",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00739007",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1043745",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "8871180",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BS",
"identifier": "9411LE",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.