Individual provider Active NPI

Matthew Douglas Olson

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1396031720
Registry record updated Nov 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60216895 Issued in WA
Practice address
4545 41St Ave SW
Seattle, WA 98116-4220
Phone
(206) 932-8363
Fax
(206) 932-4973
NPI assigned
Jun 23, 2011
Last updated
Nov 28, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2014

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 PT60216895 WA Primary

Addresses

Primary practice location

4545 41St Ave SW
Seattle, WA 98116-4220

Mailing address

16083 SW Upper Boones Ferry Rd
Suite 300
Tigard, OR 97224-7736
Phone (800) 219-8835

Other identifiers 1

IdentifierTypeStateIssuer
P01371620OtherWARR MEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110928000737 WA Practitioner - Physical Therapist in Private Practice 8426229147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapeutic Associates IncGroup PAC ID 0042116279, 319 clinicians

Practice addresses (Care Compare)

5420 Barnes Ave NW
Seattle, WA 98107-3839
Phone (206) 789-7975

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60216895WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Associates Inc Physical Therapist Current Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Dec 22, 2016 Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Dec 22, 2016 Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224
Phone (503) 443-6153

4250 Martin Way E
Ste 105
Olympia, WA 98516
Phone (360) 486-0640

5420 Barnes Ave NW
Seattle, WA 98107
Phone (206) 789-7975

Interoperability endpoints

  • Direct secure messaging: matthew.olson.1@31414.direct.athenahealth.com

Organizations & group practices 5

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": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417132800000",
    "number": "1396031720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD",
            "address_2": "SUITE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "800-219-8835",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 41ST AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164220",
            "telephone_number": "206-932-8363",
            "fax_number": "206-932-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "MATTHEW",
        "middle_name": "DOUGLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2014-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60216895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01371620",
            "state": "WA"
        }
    ],
    "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 Nov 28, 2014; 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.