Individual provider Active NPI

Kevin J Hansen, PT

  • Physical Therapist
  • Bellevue, WA
National Provider Identifier
1619085529
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00005073 Issued in WA
Practice address
14850 Lake Hills Blvd
Bellevue, WA 98007-5800
Phone
(425) 957-4500
Fax
(425) 957-4600
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT00005073 WA Primary

Addresses

Primary practice location

14850 Lake Hills Blvd
Bellevue, WA 98007-5800

Mailing address

14850 Lake Hills Blvd
Bellevue, WA 98007-5800
Phone (425) 957-4500

Other identifiers 4

IdentifierTypeStateIssuer
4286018OtherWAAETNA
40180OtherWAL & I
7081425MedicaidWA
HA1632OtherWABLUE CROSS/BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120712000612 WA Practitioner - Physical Therapist in Private Practice 5799940995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14850 Lake Hills Blvd
Bellevue, WA 98007-5800
Phone (425) 957-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00005073WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hansen Therapeutic Services, Inc. Physical Therapist CurrentSince Mar 7, 1994 Accepting new patients

Locations

14850 Lake Hills Blvd
Bellevue, WA 98007
Phone (425) 957-4500

14850 Lake Hills Blvd
Ste B1
Bellevue, WA 98007
Phone (425) 457-4500

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.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619085529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14850 LAKE HILLS BLVD",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980075800",
            "telephone_number": "425-957-4500",
            "fax_number": "425-957-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14850 LAKE HILLS BLVD",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980075800",
            "telephone_number": "425-957-4500",
            "fax_number": "425-957-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "KEVIN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00005073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4286018",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "40180",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7081425",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "HA1632",
            "state": "WA"
        }
    ],
    "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 Jul 8, 2007; 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.