Individual provider Active NPI

Benjamin McIntyre Kelch, PTA

  • Physical Therapy Assistant
  • Seattle, WA
National Provider Identifier
1326857335
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P160761922 Issued in WA
Practice address
1448 NW Market St Ste 200
Seattle, WA 98107-3743
Phone
(206) 860-2210
NPI assigned
Jan 3, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X P160761922 WA Primary

Addresses

Primary practice location

1448 NW Market St Ste 200
Seattle, WA 98107-3743

Mailing address

1448 NW Market St Ste 200
Seattle, WA 98107-3743
Phone (206) 329-1760

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P160761922WAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC PastSince Jan 5, 2025 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1735862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1326857335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 NW MARKET ST STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073743",
            "telephone_number": "206-329-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 NW MARKET ST STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073743",
            "telephone_number": "206-860-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELCH",
        "first_name": "BENJAMIN",
        "middle_name": "MCINTYRE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-03",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160761922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.