Theodore Su, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT61382998 Issued in WA

Practice address

13425 SE 30TH St Ste 2C
Bellevue, WA 98005-4450

Phone

(425) 800-4488

NPI assigned

Aug 10, 2021

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

Medicare fee-for-service enrollment

Enrolled in MA, WA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Everett Physical Therapy and Sport Performance Center PLLCGroup PAC ID 3779475181, 23 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.

• Everett Physical Therapy and Sport Performance Center PLLC

  • Physical Therapist
  • Everett, WA
  • NPI 1699713370
  Medicare reassignment Care Compare group NPD
• Proex Physical Therapy, LLC

  • Physical Therapist
  • Woburn, MA
  • NPI 1831190453
  Medicare reassignment NPD
• Everett Physical Therapy and Sport Performance Center PLLC

  • Durable Medical Equipment & Medical Supplies
  • Bothell, WA
  • NPI 1447047477
  NPD
• Proex Physical Therapy, LLC

  • Occupational Therapist
  • Boston, MA
  • NPI 1508757956
  NPD
• Everett Physical Therapy and Sport Performance Center PLLC

  dba Sports Physical Therapy Kirkland

  • Physical Therapist
  • Kirkland, WA
  • NPI 1003272675
  NPD (past)

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1336814649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W SAM HOUSTON PKWY S STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422453",
            "telephone_number": "877-234-8034",
            "fax_number": "713-430-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13425 SE 30TH ST STE 2C",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980054450",
            "telephone_number": "425-800-4488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "431 River St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Waltham",
            "state": "MA",
            "postal_code": "024535483",
            "country_code": "US",
            "telephone_number": "781-314-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SU",
        "first_name": "THEODORE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-10",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61382998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Su, LMHCA
• Dan Su, FNP-C
• Helen Su
• Jia Su, PHARM. D
• Jolyn Su, DDS
• Yi Su
• Su's Holistic Healing PLLC
• Angelica Suarez
• Lara Subhash
• Aarthi Subramani, M.D

• Physical Therapist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.