NPIMap

Organization Active NPI

Rehabilitation Institute of Washington PLLC

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1457433104
Registry record updated Jul 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
REHABILITATION INSTITUTE OF WASHINGTON PLLC
Practice address
415 1St Ave N
Suite 200
Seattle, WA 98109-4744
Phone
(206) 859-5030
Fax
(206) 859-5031
NPI assigned
Oct 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Heather Roma Kroll, MDNPI 1538264619
Title
Medical Director
Phone
(206) 859-5030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

415 1St Ave N
Suite 200
Seattle, WA 98109-4744

Mailing address

415 1St Ave N
Suite 200
Seattle, WA 98109-4744
Phone (206) 859-5030

Other identifiers 2

IdentifierTypeStateIssuer
7799748OtherWAAETNA
2585567OtherWAUNITED HEALTHCARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060412000118 WA Part B Supplier - Clinic/Group Practice 1759390297 Receives reassigned benefits from 3 practitioners
Practice locations: Seattle, WA

National Provider Directory

National Provider Directory

Locations

415 1st Ave N
Ste 200
Seattle, WA 98109
Phone (206) 859-5030

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343260800000",
    "number": "1457433104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 1ST AVE N",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981094744",
            "telephone_number": "206-859-5030",
            "fax_number": "206-859-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 1ST AVE N",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981094744",
            "telephone_number": "206-859-5030",
            "fax_number": "206-859-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITATION INSTITUTE OF WASHINGTON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2012-07-26",
        "status": "A",
        "authorized_official_last_name": "KROLL",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "ROMA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "206-859-5030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7799748",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2585567",
            "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 Jul 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.