Individual provider Active NPI

Suminder Bhangal

  • Occupational Therapist
  • Everett, WA
National Provider Identifier
1760160535
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
61456776 Issued in WA
Practice address
10511 19TH Ave SE Ste B
Everett, WA 98208-4279
Phone
(425) 357-8885
NPI assigned
Jul 10, 2023
Last updated
Jul 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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 61456776 WA Primary

Addresses

Primary practice location

10511 19TH Ave SE Ste B
Everett, WA 98208-4279

Mailing address

10511 19TH Ave SE Ste B
Everett, WA 98208-4279

Other practice location 1

9514 4th St NE Unit 101
Lake Stevens, WA 98258-1937
Phone (425) 937-2327

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230817000633 WA Practitioner - Occupational Therapist in Private Practice 6507228913 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Rehabilitation PLLCGroup PAC ID 9133012362, 54 clinicians

Practice addresses (Care Compare)

9514 4TH St NE
Unit 101
Lake Stevens, WA 98258-1937
Phone (425) 397-2327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61456776WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Rehabilitation PLLC CurrentSince Jul 24, 2023 Accepting new patients
Cascade Rehabilitation Associates, PLLC Occupational Therapist CurrentSince Jul 24, 2023 Accepting new patients
Summit Rehabilitation PLLC Occupational Therapist Current Accepting new patients
Summit Rehabilitation PLLC Occupational Therapist CurrentSince Jul 24, 2023 Accepting new patients
Cascade Rehabilitation Associates, PLLC Occupational Therapist CurrentSince Jul 24, 2023 Accepting new patients

Locations

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

10511 19th Ave SE
Ste B
Everett, WA 98208
Phone (425) 357-8885

9514 4th St NE
Unit 101
Lake Stevens, WA 98258
Phone (425) 397-2327

Organizations & group practices 5

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": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1760160535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10511 19TH AVE SE STE B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10511 19TH AVE SE STE B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084279",
            "telephone_number": "425-357-8885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9514 4th St NE Unit 101",
            "address_purpose": "LOCATION",
            "city": "Lake Stevens",
            "state": "WA",
            "postal_code": "982581937",
            "country_code": "US",
            "telephone_number": "425-937-2327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHANGAL",
        "first_name": "SUMINDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "61456776",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 10, 2023; 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.