Individual provider Active NPI

Susan R Kabeary, PT

  • Physical Therapist
  • Puyallup, WA
National Provider Identifier
1649262304
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00000970 Issued in WA
Practice address
11019 Canyon Rd E
Ste C
Puyallup, WA 98373-3001
Phone
(253) 286-3600
Fax
(253) 286-3444
NPI assigned
Aug 18, 2005
Last updated
Jul 10, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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 PT00000970 WA Primary

Addresses

Primary practice location

11019 Canyon Rd E
Ste C
Puyallup, WA 98373-3001

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other identifiers 6

IdentifierTypeStateIssuer
7734482OtherWAAETNA
8368995MedicaidWA
192085OtherWADEPT OF L&I
8939558OtherWACRIME VICTIMS
P00268495OtherWAMEDICARE RAILROAD
3824KAOtherWAREGENCE BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041217000471 WA Practitioner - Physical Therapist in Private Practice 4385601616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apple Physical Therapy LLCGroup PAC ID 7810892072, 285 clinicians

Practice addresses (Care Compare)

11019 Canyon Rd E
Suite C
Puyallup, WA 98373-3001
Phone (253) 286-3600

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
88.06
Improvement activities
40
Cost
76.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00000970WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Sep 20, 2004 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist Current Accepting new patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Sep 20, 2004 Accepting new patients
Good Samaritan Community Healthcare Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

20821 Sr 410 E
Bonney Lake, WA 98391
Phone (253) 863-7510

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

21806 103rd Avenue Ct E
Ste 103
Graham, WA 98338
Phone (253) 847-3700

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

5605 100th St SW
Ste B
Lakewood, WA 98499
Phone (253) 284-9800

11019 Canyon Rd E
Ste C
Puyallup, WA 98373
Phone (253) 286-3600

15614 Meridian E
Ste 400
Puyallup, WA 98375
Phone (253) 840-5511

16515 Meridian E
Ste 200B
Puyallup, WA 98375
Phone (253) 840-3300

3912 10th St SE
#101
Puyallup, WA 98374
Phone (253) 848-4700

11112 Pacific Ave S
Tacoma, WA 98444
Phone (253) 537-1103

15703 Pacific Ave S
#B
Tacoma, WA 98444
Phone (253) 531-4100

3315 S 23rd St
Ste 210
Tacoma, WA 98405
Phone (253) 572-8684

4703 Pacific Hwy E
#B
Tacoma, WA 98424
Phone (253) 926-8202

3816 Bridgeport Way W
University Place, WA 98466
Phone (253) 203-3996

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1649262304",
    "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": "11019 CANYON RD E",
            "address_2": "STE C",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733001",
            "telephone_number": "253-286-3600",
            "fax_number": "253-286-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABEARY",
        "first_name": "SUSAN",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00000970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7734482",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8368995",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF L&I",
            "identifier": "192085",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8939558",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00268495",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BS",
            "identifier": "3824KA",
            "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 10, 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.

Verify at the official NPI Registry.