Individual provider Active NPI

Osheray Streeter, DPT

  • Orthopedic Physical Therapist
  • Fairbanks, AK
National Provider Identifier
1801433099
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
148772 Issued in AK
Practice address
3455 Rewak Dr Ste 106
Fairbanks, AK 99709-5024
Phone
(907) 457-5322
NPI assigned
Dec 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 148772 AK Primary

Addresses

Primary practice location

3455 Rewak Dr Ste 106
Fairbanks, AK 99709-5024

Mailing address

3455 Rewak Dr Ste 106
Fairbanks, AK 99709-5024
Phone (907) 457-5322

Other practice location 1

1560 140th Ave NE Ste 100
Bellevue, WA 98005-4571
Phone (425) 746-2475

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251014001034 CA Practitioner - Physical Therapist in Private Practice 3274969399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Mikla Dunning Physical Therapy Systems PCGroup PAC ID 0941592067, 31 clinicians

Practice addresses (Care Compare)

4990 Hillsdale Cir
Suite 100
El Dorado Hills, CA 95762-5770
Phone (916) 342-4190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
148772AKMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Motion Lab CurrentSince May 16, 2022 Accepting new patients
Mikla Dunning Physical Therapy Systems, PC CurrentSince Aug 25, 2025 Accepting new patients
Kime Performance Nevada LLC PastSince Aug 25, 2025 Accepting new patients

Locations

4990 Hillsdale Cir
Ste 100
El Dorado Hls, CA 95762
Phone (916) 342-4190

1560 140th Ave NE
Ste 100
Bellevue, WA 98005
Phone (425) 746-2475

3200 W McGraw St
Seattle, WA 98199
Phone (206) 281-7970

506 12th Ave
Seattle, WA 98122
Phone (206) 212-1213

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1801433099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 REWAK DR STE 106",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095024",
            "telephone_number": "907-457-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 REWAK DR STE 106",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095024",
            "telephone_number": "907-457-5322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1560 140th Ave NE Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980054571",
            "country_code": "US",
            "telephone_number": "425-746-2475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STREETER",
        "first_name": "OSHERAY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-06",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AK",
            "license": "148772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.