Individual provider Active NPI

Michael Bruce Bishop, DPT

  • Physical Therapist
  • Fircrest, WA
National Provider Identifier
1871570754
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00007319 Issued in WA
Practice address
4040 Orchard St W
Ste. 100
Fircrest, WA 98466-6606
Phone
(253) 564-1560
Fax
(253) 564-4449
NPI assigned
Dec 30, 2005
Last updated
Nov 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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 PT00007319 WA Primary

Addresses

Primary practice location

4040 Orchard St W
Ste. 100
Fircrest, WA 98466-6606

Mailing address

4040 Orchard St W
Ste. 100
Fircrest, WA 98466-6606
Phone (253) 564-1560

Other identifiers 1

IdentifierTypeStateIssuer
7123367MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040310001396 WA Practitioner - Physical Therapist in Private Practice 2163318221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

202 Cross St SE
Auburn, WA 98002-5406
Phone (253) 876-8190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00007319WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Mar 24, 2019 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Mar 24, 2019 Accepting new patients
Multicare Health System Physical Therapist Past Accepting new patients
Chinook Physical Therapy Assoc, PS PastSince Oct 27, 2003 Accepting new patients

Locations

202 Cross St SE
Auburn, WA 98002
Phone (253) 680-6000

15500 1st Ave S
Ste 106
Burien, WA 98148
Phone (206) 242-0855

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

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, 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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1871570754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 ORCHARD ST W",
            "address_2": "STE. 100",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666606",
            "telephone_number": "253-564-1560",
            "fax_number": "253-564-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 ORCHARD ST W",
            "address_2": "STE. 100",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666606",
            "telephone_number": "253-564-1560",
            "fax_number": "253-564-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "MICHAEL",
        "middle_name": "BRUCE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00007319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7123367",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fircrest, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.