NPIMap

Organization Active NPI

Therapy Management Services, PLLC

  • Physical Therapist
  • Bonney Lake, WA
National Provider Identifier
1689224982
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
THERAPY MANAGEMENT SERVICES, PLLC
Practice address
21525 State Route 410 E Ste B
Bonney Lake, WA 98391-4101
Phone
(253) 826-8520
Fax
(253) 826-8522
NPI assigned
Sep 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Authorized official

Name
Dwan Ayala
Title
Credentialing Coordinator
Phone
(425) 450-9474

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

21525 State Route 410 E Ste B
Bonney Lake, WA 98391-4101

Mailing address

915 118TH Ave SE Ste 110
Bellevue, WA 98005-3875
Phone (425) 450-9474

Other practice location 1

2726 Griffin Ave Ste C
Enumclaw, WA 98022-2362
Phone (360) 802-6757

Other practice location 2

3021 Griffin Ave
Enumclaw, WA 98022-2369
Phone (360) 802-6757

Other names 3

  • Performance Physical Therapy Doing business as
  • Performance Physical Therapy - Bonney Lake Doing business as
  • Performance Physical Therapy - Enumclaw Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161213001176 WA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0143500983 Receives reassigned benefits from 173 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marysville, WA; Mercer Island, WA; Mount Vernon, WA; North Bend, WA; Puyallup, WA; Redmond, WA; Seattle, WA; Sedro Woolley, WA…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory

Locations

915 118th Ave SE
Ste 110
Bellevue, WA 98005
Phone (425) 243-6922

3021 Griffin Ave
Enumclaw, WA 98022
Phone (253) 833-6241

NPI Registry JSON

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569283200000",
    "number": "1689224982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 118TH AVE SE STE 110",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980053875",
            "telephone_number": "425-450-9474",
            "fax_number": "425-452-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21525 STATE ROUTE 410 E STE B",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983914101",
            "telephone_number": "253-826-8520",
            "fax_number": "253-826-8522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2726 Griffin Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Enumclaw",
            "state": "WA",
            "postal_code": "980222362",
            "country_code": "US",
            "telephone_number": "360-802-6757",
            "fax_number": "360-802-6756",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3021 Griffin Ave",
            "address_purpose": "LOCATION",
            "city": "Enumclaw",
            "state": "WA",
            "postal_code": "980222369",
            "country_code": "US",
            "telephone_number": "360-802-6757",
            "fax_number": "360-802-6756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THERAPY MANAGEMENT SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-18",
        "last_updated": "2019-09-24",
        "status": "A",
        "authorized_official_last_name": "AYALA",
        "authorized_official_first_name": "DWAN",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "425-450-9474"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Performance Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Performance Physical Therapy - Bonney Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Performance Physical Therapy - Enumclaw",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bonney Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.