Active NPI
Bryn Zachary Yoshida, DPT
- Physical Therapist
- Puyallup, WA
National Provider Identifier
1497047286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT60220920
- Practice address
- 3912 10TH St SE
#101
Puyallup, WA 98374-2188 - Phone
- (253) 848-4700
- Fax
- (253) 848-2284
- NPI assigned
- May 11, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT60220920 | WA | Primary |
Addresses
Primary practice location
3912 10TH St SE
#101
Puyallup, WA 98374-2188
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0291641 | Other | WA | DEPT. OF LABOR AND INDUSTRIES |
| P01182296 | Other | WA | MEDICARE RAILROAD |
| 1497047286 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
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
Practice addresses (Care Compare)
3819 Monroe Ave
Pittsford, NY 14534-1336
Phone (585) 586-3819
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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 and National Provider Directory roles.
-
- Physical Therapist
- Pittsford, NY
- NPI 1538428461
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437177600000",
"number": "1497047286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223",
"fax_number": "630-759-9510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3912 10TH ST SE",
"address_2": "#101",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983742188",
"telephone_number": "253-848-4700",
"fax_number": "253-848-2284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOSHIDA",
"first_name": "BRYN",
"middle_name": "ZACHARY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-11",
"last_updated": "2015-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT60220920",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT. OF LABOR AND INDUSTRIES",
"identifier": "0291641",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P01182296",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1497047286",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2015; 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.