Timothy Michael Mansour, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

60401257 Issued in WA

Practice address

9483 Oak Bay Rd
Port Ludlow, WA 98365-9794

Phone

(360) 437-2444

NPI assigned

Aug 21, 2013

Last updated

Feb 13, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Active Life Physical Therapy LLCGroup PAC ID 2365452315, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.64 of 100Reported as group

Quality

75.91

Improvement activities

40

Cost

70.93

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Active Life Physical Therapy, LLC

  • Physical Therapist
  • Port Ludlow, WA
  • NPI 1598818262
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1629402052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9483 OAK BAY RD",
            "city": "PORT LUDLOW",
            "state": "WA",
            "postal_code": "983659794",
            "telephone_number": "360-437-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9483 OAK BAY RD",
            "city": "PORT LUDLOW",
            "state": "WA",
            "postal_code": "983659794",
            "telephone_number": "360-437-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "TIMOTHY",
        "middle_name": "MICHAEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-21",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60311",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "60401257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faye King, PT, DPT
• Madeline Camille Kunze, LMT
• Michael David Leu, N.D.
• Madrona Hill Urgent Care LLC
• Lauren Corbett Mahan, M.S.
• Dana Marklund Tharaldsen, CDPT / AAC
• Marc M McManus, PA-C
• Willow Odonnell, LMT
• Lloyd Russell Owen Jr.
• Pacific Vascular Incorporated

• Physical Therapist in Port Ludlow, WA
• Providers in Port Ludlow, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; 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.