Individual provider Active NPI

Patrick S McBride, DPT

  • Physical Therapist
  • Mount Vernon, WA
National Provider Identifier
1417957044
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00009100 Issued in WA
Practice address
110 N Laventure Rd
Ste a
Mount Vernon, WA 98273-3901
Phone
(360) 428-2700
Fax
(360) 428-2701
NPI assigned
Jul 26, 2005
Last updated
Apr 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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 PT00009100 WA Primary

Addresses

Primary practice location

110 N Laventure Rd
Ste a
Mount Vernon, WA 98273-3901

Mailing address

110 N Laventure Rd
Ste a
Mount Vernon, WA 98273-3901
Phone (360) 428-2700

Other identifiers 2

IdentifierTypeStateIssuer
7155104MedicaidWA
P00006691OtherWARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110125000700 WA Practitioner - Physical Therapist in Private Practice 3072792910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Burlington Physical Therapy, LLCGroup PAC ID 2466485933, 2 clinicians

Practice addresses (Care Compare)

1186 S Burlington Blvd
Burlington, WA 98233-3314
Phone (360) 757-9018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00009100WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Burlington Physical Therapy, LLC Physical Therapist CurrentSince Jul 1, 2022 Accepting new patients

Locations

1186 S Burlington Blvd
Burlington, WA 98233
Phone (360) 757-9018

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, 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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1417957044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N LAVENTURE RD",
            "address_2": "STE A",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982733901",
            "telephone_number": "360-428-2700",
            "fax_number": "360-428-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N LAVENTURE RD",
            "address_2": "STE A",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982733901",
            "telephone_number": "360-428-2700",
            "fax_number": "360-428-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "PATRICK",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7155104",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00006691",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.