Individual provider Active NPI

Graciella Jessica Raagas Macolor

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1659079796
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
61300061 Issued in WA
Practice address
820 NW 95TH St
Seattle, WA 98117-2207
Phone
(206) 356-1532
NPI assigned
Feb 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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 61300061 WA Primary

Addresses

Primary practice location

820 NW 95TH St
Seattle, WA 98117-2207

Mailing address

2121 6TH Ave Apt N1812
Seattle, WA 98121-2857
Phone (206) 571-1794

Other names 1

  • Graciella Jessica Arce Raagas Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240924000673 WA Practitioner - Physical Therapist in Private Practice 5294276812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacmed ClinicsGroup PAC ID 2466350657, 211 clinicians

Practice addresses (Care Compare)

1200 12TH Ave S
Seattle, WA 98144-2712
Phone (206) 326-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61300061WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacmed Clinics CurrentSince Jul 15, 2024 Accepting new patients
Pacmed Clinics Current Accepting new patients
Pacmed Clinics CurrentSince Jul 15, 2024 Accepting new patients

Locations

220 15th Ave SE
Puyallup, WA 98372
Phone (253) 435-3400

1200 12th Ave S
Seattle, WA 98144
Phone (206) 326-2400

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

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": "1676592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1659079796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 6TH AVE APT N1812",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981212857",
            "telephone_number": "206-571-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 NW 95TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981172207",
            "telephone_number": "206-356-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACOLOR",
        "first_name": "GRACIELLA JESSICA",
        "middle_name": "RAAGAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "61300061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACIELLA JESSICA",
            "last_name": "RAAGAS",
            "middle_name": "ARCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.