NPIMap

Organization Active NPI

Summit Rehabilitation PLLC

  • Physical Therapist
  • Mukilteo, WA
National Provider Identifier
1699667600
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SUMMIT REHABILITATION PLLC
Practice address
12121 Harbour Reach Dr Ste 100
Mukilteo, WA 98275-5314
Phone
(425) 354-5110
NPI assigned
Jul 16, 2025
Last updated
Jul 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Authorized official

Name
Nicholas Poan
Title
Cfo
Phone
(714) 402-0829

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

12121 Harbour Reach Dr Ste 100
Mukilteo, WA 98275-5314

Mailing address

2600 Dallas Pkwy Ste 290
Frisco, TX 75034-7493
Phone (945) 260-0010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251010002939 WA DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 9133012362 Practice locations: Mukilteo, WA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Summit Rehabilitation PLLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1752624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1699667600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 DALLAS PKWY STE 290",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750347493",
            "telephone_number": "945-260-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 HARBOUR REACH DR STE 100",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982755314",
            "telephone_number": "425-354-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT REHABILITATION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "POAN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "714-402-0829"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukilteo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.