Individual provider Active NPI

Sadiya Mukhtar

  • Physical Therapist
  • Federal Way, WA
National Provider Identifier
1790114031
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60130866 Issued in WA
Practice address
728 S 320TH St Ste G
Federal Way, WA 98003-5255
Phone
(253) 448-2174
NPI assigned
Nov 7, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 60130866 WA Primary

Addresses

Primary practice location

728 S 320TH St Ste G
Federal Way, WA 98003-5255

Mailing address

1940 S Bonito Way Ste 190
Meridian, ID 83642-5618
Phone (208) 287-9420

Other practice location 1

2031 236th Ave NE
Sammamish, WA 98074-3530
Phone (469) 556-9757

Other practice location 2

17833 1st Ave S Ste A
Normandy Park, WA 98148-1713
Phone (253) 330-8518

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220307001459 WA Practitioner - Physical Therapist in Private Practice 5092109165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60130866WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kindstead Home Care LLC Current Accepting new patients

Organizations & group practices 1

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": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1790114031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 S BONITO WAY STE 190",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425618",
            "telephone_number": "208-287-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 S 320TH ST STE G",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035255",
            "telephone_number": "253-448-2174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2031 236th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Sammamish",
            "state": "WA",
            "postal_code": "980743530",
            "country_code": "US",
            "telephone_number": "469-556-9757",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17833 1st Ave S Ste A",
            "address_purpose": "LOCATION",
            "city": "Normandy Park",
            "state": "WA",
            "postal_code": "981481713",
            "country_code": "US",
            "telephone_number": "253-330-8518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUKHTAR",
        "first_name": "SADIYA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2023-02-22",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "60130866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.