Individual provider Active NPI

Maryam Khaniyan, OT

  • Occupational Therapist
  • Bellevue, WA
National Provider Identifier
1740772730
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT60851310 Issued in WA
Practice address
1515 116TH Ave NE Ste 107
Bellevue, WA 98004
Phone
(425) 827-5877
Fax
(425) 827-5843
NPI assigned
Jun 5, 2018
Last updated
Jun 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT60851310 WA Primary

Addresses

Primary practice location

1515 116TH Ave NE Ste 107
Bellevue, WA 98004

Mailing address

4220 132ND St SE Ste 101
Mill Creek, WA 98012-8999
Phone (425) 686-7858

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180728000074 WA Practitioner - Occupational Therapist in Private Practice 8729335302 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy Management Services PLLCGroup PAC ID 0143500983, 107 clinicians

Practice addresses (Care Compare)

12910 Totem Lake Blvd NE
Suite 130
Kirkland, WA 98034-2955
Phone (425) 823-8055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Group, PC CurrentSince Jun 6, 2018 Accepting new patients
Integrated Rehabilitation Group, PC Occupational Therapist CurrentSince Jun 6, 2018 Accepting new patients
Everett Physical Therapy and Sport Performance Center PLLC CurrentSince Jun 6, 2018 Accepting new patients
Everett Physical Therapy and Sport Performance Center PLLC CurrentSince Jun 6, 2018 Accepting new patients
Therapy Management Services, PLLC Current Accepting new patients
Therapy Management Services, PLLC Occupational Therapist CurrentSince Dec 1, 2020 Accepting new patients
Therapy Management Services, PLLC Occupational Therapist Past Accepting new patients

Locations

1300 W Sam Houston Pkwy S
Ste 300
Houston, TX 77042
Phone (713) 297-7052

875 Wesley St
Ste 220
Arlington, WA 98223
Phone (425) 337-3166

11711 NE 12th St
Ste 3A
Bellevue, WA 98005
Phone (425) 454-1405

1515 116th Ave NE
Ste 107
Bellevue, WA 98004
Phone (425) 646-7800

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

814 DuPont St
Bellingham, WA 98225
Phone (360) 671-2900

275 SW 160th St
Ste 105
Burien, WA 98166
Phone (206) 513-2155

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

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

403 W Stanley St
Granite Falls, WA 98252
Phone (360) 691-4835

12910 Totem Lake Blvd NE
Ste 105
Kirkland, WA 98034
Phone (425) 823-8631

12910 Totem Lake Blvd NE
Ste 130
Kirkland, WA 98034
Phone (425) 823-8055

19217 36th Ave W
Ste 102
Lynnwood, WA 98036
Phone (425) 670-9991

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

111 Market St NE
Ste 108
Olympia, WA 98501
Phone (360) 754-7085

1707 3rd St SE
Puyallup, WA 98372
Phone (253) 200-2355

3801 5th St SE
Ste 220
Puyallup, WA 98374
Phone (253) 445-4258

22500 NE Marketplace Dr
Ste 204
Redmond, WA 98053
Phone (425) 836-1034

709 Cook Rd
Sedro Woolley, WA 98284
Phone (360) 873-8191

1830 Bickford Ave
Ste 209
Snohomish, WA 98290
Phone (360) 568-7774

14229 NE Woodinville Duvall Rd
Ste 25
Woodinville, WA 98072
Phone (425) 658-0110

Organizations & group practices 7

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": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1740772730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 132ND ST SE STE 101",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980128999",
            "telephone_number": "425-686-7858",
            "fax_number": "425-341-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 116TH AVE NE STE 107",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-827-5877",
            "fax_number": "425-827-5843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANIYAN",
        "first_name": "MARYAM",
        "name_prefix": "Ms.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60851310",
            "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 Jun 6, 2018; 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.