Individual provider Active NPI

Brett Nikol Lezamiz, PHYSICAL THERAPIST

  • Physical Therapist
  • Bellevue, WA
National Provider Identifier
1689657538
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00009488 Issued in WA
Practice address
1605 116TH Ave NE
Suite 110
Bellevue, WA 98004-3034
Phone
(425) 450-9801
Fax
(425) 450-9778
NPI assigned
Nov 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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 PT00009488 WA Primary

Addresses

Primary practice location

1605 116TH Ave NE
Suite 110
Bellevue, WA 98004-3034

Mailing address

1605 116TH Ave NE
Suite 110
Bellevue, WA 98004-3034
Phone (425) 450-9801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00009488WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 Current Accepting new patients
Washington Luna Care Physical Therapy LLC Physical Therapist CurrentSince Jan 6, 2022 Accepting new patients
King County Public Hospital District No. 2 Physical Therapist CurrentSince Mar 1, 2022 Accepting new patients
Bellevue Sports & Spine Physical Therapy PS Physical Therapist PastSince Mar 20, 2021 Accepting new patients
Factoria Sports and Spine Physical Therapy P S Physical Therapist PastSince Jan 14, 2002 Accepting new patients

Locations

13555 SE 36th St
Ste 100
Bellevue, WA 98006

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

12040 NE 128th St
#10
Kirkland, WA 98034
Phone (206) 466-0369

Organizations & group practices 5

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": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1689657538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 116TH AVE NE",
            "address_2": "SUITE 110",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043034",
            "telephone_number": "425-450-9801",
            "fax_number": "425-450-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 116TH AVE NE",
            "address_2": "SUITE 110",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043034",
            "telephone_number": "425-450-9801",
            "fax_number": "425-450-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEZAMIZ",
        "first_name": "BRETT",
        "middle_name": "NIKOL",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.