Individual provider Active NPI

Benjamin Michael Boyle, DPT, CSCS

  • Physical Therapist
  • Everett, WA
National Provider Identifier
1861552747
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60108164 Issued in WA
Practice address
2000 Hewitt Ave
Suite 115
Everett, WA 98201-3600
Phone
(425) 252-3908
Fax
(425) 252-7940
NPI assigned
Dec 11, 2006
Last updated
Mar 10, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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 PT01915 RI
Physical Therapist 225100000X PT60108164 WA Primary

Addresses

Primary practice location

2000 Hewitt Ave
Suite 115
Everett, WA 98201-3600

Mailing address

20117 25TH Dr SE
Bothell, WA 98012-7603
Phone (401) 529-6589

Other identifiers 3

IdentifierTypeStateIssuer
0013BOOtherWAREGENCE
8589996OtherWADSHS
0253337OtherWAL&I

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091005000256 WA Practitioner - Physical Therapist in Private Practice 1557407608 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10207 19TH Ave SE
Everett, WA 98208-4257
Phone (425) 337-3166

13242 Aurora Ave N
Suite 103
Seattle, WA 98133-7026
Phone (206) 420-0221

1332 Colby Ave
Everett, WA 98201-1618
Phone (425) 470-4040

1651 Cooper Point Rd SW
Olympia, WA 98502-5735
Phone (360) 956-1100

17792 147TH St SE
Monroe, WA 98272-1030
Phone (360) 464-4358

2707 171St PL NE
Suite 101
Marysville, WA 98271-4740
Phone (360) 386-7401

2821 NW Market St
Suite B
Seattle, WA 98107-5815
Phone (206) 706-0063

300 Lilly Rd NE
Suite B
Olympia, WA 98506-5428
Phone (360) 352-7352

3201 Commercial Ave
Suite a
Anacortes, WA 98221-2761
Phone (360) 682-0361

3732 Colby Ave
Everett, WA 98201-4911
Phone (425) 374-2846

403 W Stanley St
Granite Falls, WA 98252-8631
Phone (360) 691-4835

514 N 85TH St
Seattle, WA 98103-3721
Phone (206) 900-8883

722 E University Way
Ellensburg, WA 98926-2947
Phone (509) 962-1553

848 N Sunrise Blvd
Suite F104
Camano Island, WA 98282-8770
Phone (360) 386-7051

919 State Ave
Suite 101
Marysville, WA 98270-4284
Phone (360) 386-7405

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT01915RIMDPhysical Therapist
PT60108164WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Dec 1, 2018 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Dec 1, 2018 Accepting new patients
Snohomish Physical Therapy PLLC Physical Therapist CurrentSince Dec 1, 2018 Accepting new patients
Everett Physical Therapy and Sport Performance Center PLLC CurrentSince Sep 8, 2009 Accepting new patients
Snohomish Physical Therapy PLLC Physical Therapist CurrentSince Dec 1, 2018 Accepting new patients
Everett Physical Therapy and Sport Performance Center PLLC Physical Therapist CurrentSince Sep 8, 2009 Accepting new patients

Locations

1300 W Sam Houston Pkwy S
Ste 300
Houston, TX 77042
Phone (713) 297-7052

875 Wesley St
Ste 220
Arlington, WA 98223
Phone (425) 337-3166

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

2000 Hewitt Ave
Ste 115
Everett, WA 98201
Phone (425) 252-3908

403 W Stanley St
Granite Falls, WA 98252
Phone (360) 691-4835

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

111 Market St NE
Ste 108
Olympia, WA 98501
Phone (360) 754-7085

22500 NE Marketplace Dr
Ste 204
Redmond, WA 98053
Phone (425) 836-1034

1830 Bickford Ave
Ste 209
Snohomish, WA 98290
Phone (360) 568-7774

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268179200000",
    "number": "1861552747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20117 25TH DR SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980127603",
            "telephone_number": "401-529-6589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 HEWITT AVE",
            "address_2": "SUITE 115",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013600",
            "telephone_number": "425-252-3908",
            "fax_number": "425-252-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "BENJAMIN",
        "middle_name": "MICHAEL",
        "credential": "DPT, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2010-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT01915",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60108164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "0013BO",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS",
            "identifier": "8589996",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0253337",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; 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.