Individual provider Active NPI

James Ravotti

  • Physical Therapist
  • Renton, WA
National Provider Identifier
1790137164
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60638270 Issued in WA
Practice address
14028 SE Petrovitsky Rd
Renton, WA 98058-8933
Phone
(425) 272-0252
Fax
(425) 272-0291
NPI assigned
Jul 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 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 60638270 WA Primary

Addresses

Primary practice location

14028 SE Petrovitsky Rd
Renton, WA 98058-8933

Mailing address

790 Remington Blvd Ste 300
Bolingbrook, IL 60440-4909

Other identifiers 1

IdentifierTypeStateIssuer
1790137164MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160906002643 WA Practitioner - Physical Therapist in Private Practice 3577859263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apple Physical Therapy LLCGroup PAC ID 7810892072, 285 clinicians

Practice addresses (Care Compare)

26545 Maple Valley Black Diamond Rd
Suite K 160
Maple Valley, WA 98038-8391
Phone (425) 578-7211

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
88.06
Improvement activities
40
Cost
76.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60638270WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Physical Therapy, LLC Physical Therapist Current Accepting new patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Mar 11, 2019 Accepting new patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Mar 11, 2019 Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist PastSince Jul 11, 2016 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

790 Remington Blvd
Ste 300
Bolingbrook, IL 60440

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

720 12th St SE
Auburn, WA 98002
Phone (253) 735-3606

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

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

405 NW Gilman Blvd
Ste 200
Issaquah, WA 98027
Phone (425) 392-6804

25248 Pacific Hwy S
Ste 104
Kent, WA 98032
Phone (253) 237-5012

12926 SE Kent Kangley Rd
Kent, WA 98030
Phone (253) 216-1041

25248 Pacific Hwy S
Kent, WA 98032

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

26545 Black Diamond Rd SE
#K160
Maple Valley, WA 98038
Phone (425) 578-7211

7650 SE 27th St
Ste 112
Mercer Island, WA 98040
Phone (206) 230-8320

6985 Coal Creek Pkwy SE
Newcastle, WA 98059
Phone (425) 378-0500

17650 140th Ave SE
Ste B7
Renton, WA 98058
Phone (425) 430-0700

17800 Talbot Rd S
Ste D
Renton, WA 98055
Phone (425) 277-9096

916 N 10th Pl
Bldg 306
Renton, WA 98057
Phone (425) 207-7850

4820 NE 4th St
Ste A104
Renton, WA 98059
Phone (425) 207-7043

2600 SW Barton St
Ste D3
Seattle, WA 98126
Phone (206) 573-5074

Organizations & group practices 6

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": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1790137164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD STE 300",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14028 SE PETROVITSKY RD",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980588933",
            "telephone_number": "425-272-0252",
            "fax_number": "425-272-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVOTTI",
        "first_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-08",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "60638270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790137164",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.