Individual provider Active NPI

Jennifer Kraft Pesce, PT

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1417032228
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00006943 Issued in WA
Practice address
Uw Campus
East Stevens Circle
Seattle, WA 98195-4410
Phone
(206) 616-2495
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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 PT00006943 WA Primary

Addresses

Primary practice location

Uw Campus
East Stevens Circle
Seattle, WA 98195-4410

Mailing address

1937 25TH Ave E
Seattle, WA 98112-3009
Phone (206) 250-7975

Other identifiers 2

IdentifierTypeStateIssuer
2001457OtherINTERNAL ID-MOTOR VEHICLE ID
8382129MedicaidWA

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

LicenseStateTypeSpecialty
PT00006943WAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1417032228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1937 25TH AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981123009",
            "telephone_number": "206-250-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UW CAMPUS",
            "address_2": "EAST STEVENS CIRCLE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981954410",
            "telephone_number": "206-616-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESCE",
        "first_name": "JENNIFER",
        "middle_name": "KRAFT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00006943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL ID-MOTOR VEHICLE ID",
            "identifier": "2001457",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8382129",
            "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 Apr 29, 2015; 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.