Individual provider Active NPI

Gillian Sukachevin, M.S.P.T.

  • Physical Therapist
  • Takoma Park, MD
National Provider Identifier
1669697603
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19359 Issued in MD
Practice address
7600 Carroll Ave
Takoma Park, MD 20912-6367
Phone
(301) 891-5390
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 19359 MD Primary
Physical Therapist 225100000X PT3068 DC

Addresses

Primary practice location

7600 Carroll Ave
Takoma Park, MD 20912-6367

Mailing address

1940 Kimberly Rd
Silver Spring, MD 20903-1219

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140128001994 WA Practitioner - Physical Therapist in Private Practice 4486883170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapeutic Associates IncGroup PAC ID 0042116279, 319 clinicians

Practice addresses (Care Compare)

3180 NE 3Rd Ave
Camas, WA 98607-2407
Phone (360) 335-9033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT3068DCMDPhysical Therapist
19359MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Associates Inc Physical Therapist CurrentSince Aug 1, 2020 Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Aug 1, 2020 Accepting new patients
Therapeutic Associates Inc Physical Therapist Current Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224
Phone (503) 443-6153

3180 NE 3rd Ave
Camas, WA 98607
Phone (360) 335-9033

1408 N Louisiana St
Ste 104A
Kennewick, WA 99336
Phone (509) 783-1962

17901 Bothell Everett Hwy
Mill Creek, WA 98012
Phone (425) 424-3924

5420 Barnes Ave NW
Seattle, WA 98107
Phone (206) 789-7975

17700 SE Mill Plain Blvd
Ste 150
Vancouver, WA 98683
Phone (360) 514-9383

Interoperability endpoints

  • Direct secure messaging: gillian.sukachevin.1@31414.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669697603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 KIMBERLY RD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209031219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 CARROLL AVE",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209126367",
            "telephone_number": "301-891-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUKACHEVIN",
        "first_name": "GILLIAN",
        "credential": "M.S.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19359",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT3068",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Takoma Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.