Individual provider Active NPI

Guru Parkash Khalsa

  • Physical Therapist
  • Lacey, WA
National Provider Identifier
1649995986
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
61345658 Issued in WA
Practice address
1445 Galaxy Dr NE Ste 301
Lacey, WA 98516-4754
Phone
(360) 456-1444
NPI assigned
Oct 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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 61345658 WA Primary

Addresses

Primary practice location

1445 Galaxy Dr NE Ste 301
Lacey, WA 98516-4754

Mailing address

1445 Galaxy Dr NE Ste 301
Lacey, WA 98516-4754

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221118002700 WA Practitioner - Physical Medicine and Rehabilitation 1355719568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penrose and Associates Physical Therapy LLCGroup PAC ID 1052403896, 11 clinicians

Practice addresses (Care Compare)

1445 Galaxy Dr NE
Suite 301
Lacey, WA 98516-4754
Phone (360) 456-1444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61345658WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Penrose & Associates Physical Therapy LLC CurrentSince Oct 10, 2022 Accepting new patients

Locations

1445 Galaxy Dr NE
Ste 301
Lacey, WA 98516
Phone (360) 456-1444

1445 Galaxy Dr NE
Lacey, WA 98516
Phone (360) 456-1444

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": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1649995986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 GALAXY DR NE STE 301",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985164754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 GALAXY DR NE STE 301",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985164754",
            "telephone_number": "360-456-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALSA",
        "first_name": "GURU PARKASH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "61345658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

Verify at the official NPI Registry.