NPIMap

Organization Active NPI

520 Physical Therapy, LLC

Doing business as HIDEF Physical Therapy

  • Physical Therapy Clinic/Center
  • Bellevue, WA
National Provider Identifier
1740864982
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
520 PHYSICAL THERAPY, LLC
Doing business as
HIDEF Physical Therapy
Practice address
13112 NE 20TH St Ste 400
Bellevue, WA 98005-2045
Phone
(206) 693-9929
Fax
(206) 922-8909
NPI assigned
May 12, 2021
Last updated
May 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Authorized official

Name
Walston Zachary Smith, DPTNPI 1114442365
Title
Co-Owner
Phone
(206) 693-9929

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

13112 NE 20TH St Ste 400
Bellevue, WA 98005-2045

Mailing address

26431 233Rd Ave SE
Maple Valley, WA 98038
Phone (206) 693-9929

Other names 1

  • HIDEF Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210811003818 WA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2062816168 Receives reassigned benefits from 11 practitioners
Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory

Locations

13112 NE 20th St
Ste 400
Bellevue, WA 98005
Phone (253) 218-9539

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1740864982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26431 233RD AVE SE",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "98038",
            "telephone_number": "206-693-9929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13112 NE 20TH ST STE 400",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052045",
            "telephone_number": "206-693-9929",
            "fax_number": "206-922-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "520 PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "WALSTON",
        "authorized_official_middle_name": "ZACHARY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "206-693-9929",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HIDEF Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 12, 2021; 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.