Individual provider Active NPI

Skyler P. Tateishi, DPT

  • Physical Therapist
  • Bellevue, WA
National Provider Identifier
1407231707
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60568633 Issued in WA
Practice address
1200 112TH Ave NE
Suite C260
Bellevue, WA 98004-3732
Phone
(425) 462-5006
Fax
(425) 462-5019
NPI assigned
Jul 28, 2015
Last updated
Sep 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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 PT60568633 WA Primary

Addresses

Primary practice location

1200 112TH Ave NE
Suite C260
Bellevue, WA 98004-3732

Mailing address

805 Madison St
Suite 901
Seattle, WA 98104-1172

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191001003187 WA Practitioner - Physical Therapist in Private Practice 0749510915 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy Management Services PLLCGroup PAC ID 0143500983, 107 clinicians

Practice addresses (Care Compare)

10564 5TH Ave NE
Suite 205
Seattle, WA 98125-7200
Phone (206) 486-3337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60568633WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Management Services, PLLC Physical Therapist CurrentSince Mar 1, 2020 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Therapy Management Services, PLLC Physical Therapist Current Accepting new patients
Therapy Management Services, PLLC Physical Therapist CurrentSince Mar 1, 2020 Accepting new patients
Proliance Surgeons Inc P S CurrentSince Oct 1, 2019 Accepting new patients
Proliance Surgeons, Inc., P.S. Physical Therapist CurrentSince Oct 1, 2019 Accepting new patients
Therapy Management Services, PLLC Physical Therapist Past Accepting new patients

Locations

11711 NE 12th St
Ste 3A
Bellevue, WA 98005
Phone (425) 454-1405

1200 112th Ave NE
Ste C260
Bellevue, WA 98004
Phone (425) 313-3055

15500 1st Ave S
Ste 106
Burien, WA 98148
Phone (206) 242-0855

12910 Totem Lake Blvd NE
Ste 105
Kirkland, WA 98034
Phone (425) 823-8631

19217 36th Ave W
Ste 102
Lynnwood, WA 98036
Phone (425) 670-9991

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

906 NE 45th St
Seattle, WA 98105
Phone (206) 347-0414

10564 5th Ave NE
Ste 205
Seattle, WA 98125
Phone (206) 357-4093

Organizations & group practices 7

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": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1407231707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 112TH AVE NE",
            "address_2": "SUITE C260",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043732",
            "telephone_number": "425-462-5006",
            "fax_number": "425-462-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATEISHI",
        "first_name": "SKYLER",
        "middle_name": "P.",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-28",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60568633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; 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.