Individual provider Active NPI

Angela Ann Stainbrook, DPT

  • Physical Therapist
  • Yakima, WA
National Provider Identifier
1790972503
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00010315 Issued in WA
Practice address
3801 Summitview Ave
Yakima, WA 98902-2794
Phone
(509) 853-3120
Fax
(509) 853-1876
NPI assigned
Sep 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 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 PT00010315 WA Primary

Addresses

Primary practice location

3801 Summitview Ave
Yakima, WA 98902-2794

Mailing address

410 S 44TH Ave
Yakima, WA 98908-3303
Phone (307) 389-1877

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071204000427 WA Practitioner - Physical Therapist in Private Practice 8224127964 Reassigns benefits to 2 organizations
Practice locations: Yakima, WA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3801 Summitview Ave
Yakima, WA 98902-2794
Phone (307) 389-1877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00010315WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premere Rehab LLC Physical Therapist CurrentSince Feb 1, 2012 Accepting new patients
Angela Ann Stainbrook Physical Therapist CurrentSince Feb 6, 2024 Accepting new patients
Premere Rehab LLC Physical Therapist CurrentSince Feb 1, 2012 Accepting new patients
RPM Rehab, Inc Physical Therapist PastSince Nov 4, 2011 Accepting new patients
Cascade Summit Physical Therapy Inc PS Physical Therapist Past Accepting new patients

Locations

8100 SW Nyberg St
Ste 200
Tualatin, OR 97062
Phone (503) 570-3365

3801 Summitview Ave
Yakima, WA 98902
Phone (509) 853-1805

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1790972503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 S 44TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083303",
            "telephone_number": "307-389-1877",
            "fax_number": "509-853-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 SUMMITVIEW AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022794",
            "telephone_number": "509-853-3120",
            "fax_number": "509-853-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAINBROOK",
        "first_name": "ANGELA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00010315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.