Individual provider Active NPI

Nelson Daniel Rojas Mieres, PT

  • Physical Therapist
  • Lacey, WA
National Provider Identifier
1760925416
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60543040 Issued in WA
Practice address
4770 Yelm Hwy SE
Lacey, WA 98503-4986
Phone
(360) 915-7369
Fax
(360) 688-7499
NPI assigned
Nov 29, 2016
Last updated
Jan 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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 PT60543040 WA Primary

Addresses

Primary practice location

4770 Yelm Hwy SE
Lacey, WA 98503-4986

Mailing address

5910 Cherokee Loop SE
Lacey, WA 98513-6205
Phone (360) 915-7369

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170105000181 WA Practitioner - Physical Therapist in Private Practice 9537440573 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VBNC Physical Therapy PLLCGroup PAC ID 1355730797, 3 clinicians

Practice addresses (Care Compare)

4770 Yelm Hwy SE
Lacey, WA 98503-4986
Phone (360) 915-7369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Nov 28, 2016 Accepting new patients
VBNC Physical Therapy PLLC Physical Therapist CurrentSince May 3, 2021 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist CurrentSince Nov 28, 2016 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

4770 Yelm Hwy SE
Lacey, WA 98503
Phone (360) 491-6074

201 Tahoma Blvd
Unit 207
Yelm, WA 98597
Phone (360) 458-6400

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": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1760925416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 CHEROKEE LOOP SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985136205",
            "telephone_number": "360-915-7369",
            "fax_number": "360-688-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 YELM HWY SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985034986",
            "telephone_number": "360-915-7369",
            "fax_number": "360-688-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROJAS MIERES",
        "first_name": "NELSON",
        "middle_name": "DANIEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-29",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60543040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.