NPIMap

Organization Active NPI

Everett Physical Therapy and Sport Performance Center PLLC

  • Physical Therapist
  • Everett, WA
National Provider Identifier
1699713370
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EVERETT PHYSICAL THERAPY AND SPORT PERFORMANCE CENTER PLLC
Practice address
2000 Hewitt Ave
#115
Everett, WA 98201
Phone
(425) 252-3908
Fax
(425) 252-7940
NPI assigned
Jun 3, 2006
Last updated
Mar 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Authorized official

Name
Richard Binstein
Title
VP/Authorized Official
Phone
(713) 297-7052

Specialties & licenses 1

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

Addresses

Primary practice location

2000 Hewitt Ave
#115
Everett, WA 98201

Mailing address

2000 Hewitt Ave Ste 115
Everett, WA 98201-3600
Phone (425) 252-3908

Other identifiers 6

IdentifierTypeStateIssuer
4702EVOtherWAREGENCE BLUESHIELD GRP #
8931865OtherWAL&I CRIME VICTIMS
9054974MedicaidWA
2029657-00OtherWAOWCP
7121858MedicaidWA
0179003OtherWADEPT. OF LABOR & INDUSTRY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040329000985 WA Part B Supplier - Clinic/Group Practice 3779475181 Receives reassigned benefits from 71 practitioners
Practice locations: Bellevue, WA; Bellingham, WA; Bothell, WA; Everett, WA; Ferndale, WA; Kirkland, WA; Lake Stevens, WA

National Provider Directory

National Provider Directory
Tax ID family
Everett Physical Therapy and Sport Performance Center PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

333 Kennedy Dr
Torrington, CT 06790
Phone (860) 489-3449

2930 Richards Rd
Ste 100
Bellevue, WA 98005
Phone (360) 318-7097

Practitioners & affiliated clinicians

Practitioners 75

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 75

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583366400000",
    "number": "1699713370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEWITT AVE STE 115",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013600",
            "telephone_number": "425-252-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 HEWITT AVE",
            "address_2": "#115",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98201",
            "telephone_number": "425-252-3908",
            "fax_number": "425-252-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERETT PHYSICAL THERAPY AND SPORT PERFORMANCE CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A",
        "authorized_official_last_name": "BINSTEIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "VP/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "713-297-7052"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD GRP #",
            "identifier": "4702EV",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I CRIME VICTIMS",
            "identifier": "8931865",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9054974",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "2029657-00",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7121858",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF LABOR & INDUSTRY",
            "identifier": "0179003",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.