Individual provider Active NPI

Bryan Simpson, DPT

  • Physical Therapist
  • Mountlake Terrace, WA
National Provider Identifier
1700266673
Registry record updated Sep 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT.60546466 Issued in WA
Practice address
6912 220TH St SW Ste 205
Mountlake Terrace, WA 98043-2169
Phone
(206) 465-3616
NPI assigned
Jun 4, 2015
Last updated
Sep 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2022

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 PT.60546466 WA Primary

Addresses

Primary practice location

6912 220TH St SW Ste 205
Mountlake Terrace, WA 98043-2169

Mailing address

20031 88TH Ave W
Edmonds, WA 98026-6620
Phone (206) 465-3616

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150813009304 WA Practitioner - Physical Therapist in Private Practice 6507171022 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Olympic Sports RehabGroup PAC ID 4284163353, 6 clinicians

Practice addresses (Care Compare)

6808 220TH St SW
Suite 303
Mountlake Terrace, WA 98043-2187
Phone (425) 650-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT.60546466WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Sports Rehab, PLLC Physical Therapist CurrentSince Jan 2, 2023 Accepting new patients
Olympic Sports Rehab Physical Therapist CurrentSince Jan 14, 2025 Accepting new patients

Locations

6808 220th St SW
Ste 303
Mountlake Terrace, WA 98043
Phone (425) 650-1900

6912 220th St SW
Ste 205
Mountlake Terrace, WA 98043
Phone (425) 712-1978

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662163200000",
    "number": "1700266673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20031 88TH AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980266620",
            "telephone_number": "206-465-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6912 220TH ST SW STE 205",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432169",
            "telephone_number": "206-465-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "BRYAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2022-09-03",
        "certification_date": "2022-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT.60546466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountlake Terrace, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2022; 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.