Individual provider Active NPI

Kyle Joseph Ordonez Canlas, DOT

  • Physical Therapist
  • Auburn, WA
National Provider Identifier
1780492272
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1398635 Issued in TX
Practice address
407 E Main St
Auburn, WA 98002-5504
Phone
(253) 545-0044
NPI assigned
Dec 30, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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 1398635 TX Primary

Addresses

Primary practice location

407 E Main St
Auburn, WA 98002-5504

Mailing address

6050 Tacoma Mall Blvd Ste 300
Tacoma, WA 98409-6828

Other names 1

  • Kyle Canlas Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250204001096 WA Practitioner - Physical Therapist in Private Practice 3375073521 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1398635TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Jan 1, 2025 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jan 1, 2025 Accepting new patients
Multicare Health System Physical Therapist PastSince Jan 5, 2025 Accepting new patients

Locations

407 E Main St
Auburn, WA 98002
Phone (253) 545-0044

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1780492272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6050 TACOMA MALL BLVD STE 300",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984096828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E MAIN ST",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980025504",
            "telephone_number": "253-545-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANLAS",
        "first_name": "KYLE JOSEPH",
        "middle_name": "ORDONEZ",
        "credential": "DOT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1398635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLE",
            "last_name": "CANLAS",
            "credential": "DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Auburn, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.