Individual provider Active NPI

Jason Kugel, PT

  • Physical Therapist
  • Centralia, WA
National Provider Identifier
1619493392
Registry record updated Aug 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60762037 Issued in WA
Practice address
1809 Cooks Hill Rd
Centralia, WA 98531-9072
Phone
(360) 330-8844
NPI assigned
Aug 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2017

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 60762037 WA Primary

Addresses

Primary practice location

1809 Cooks Hill Rd
Centralia, WA 98531-9072

Mailing address

1809 Cooks Hill Rd
Centralia, WA 98531-9072

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241013000190 WA Practitioner - Physical Therapist in Private Practice 5991237190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Loma Linda University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centralia Physical Therapy Inc PSGroup PAC ID 0648429688, 20 clinicians

Practice addresses (Care Compare)

1817 S Market Blvd
Suite C
Chehalis, WA 98532-4100
Phone (360) 996-4410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60762037WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centralia Physical Therapy Inc PS Physical Therapist CurrentSince Sep 30, 2024 Accepting new patients
Providence Health & Services Washington Physical Therapist Past Accepting new patients
Aeroflow Connect LLC PastSince Sep 30, 2024 Accepting new patients

Locations

1316 Mt Saint Helens Way NE
Ste B
Castle Rock, WA 98611
Phone (360) 557-8020

1118 View Ave
Centralia, WA 98531
Phone (360) 736-5273

1817 S Market Blvd
Ste C
Chehalis, WA 98532
Phone (360) 996-4410

19548 Vision Dr SW
Ste C
Rochester, WA 98579
Phone (360) 669-0564

Organizations & group practices 3

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": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502755200000",
    "number": "1619493392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319072",
            "telephone_number": "360-330-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUGEL",
        "first_name": "JASON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-15",
        "last_updated": "2017-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "60762037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2017; 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.