Individual provider Active NPI

Christopher Soterakopoulos, DPT, FAFS

  • Physical Therapist
  • Everett, WA
National Provider Identifier
1891042180
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60284835 Issued in WA
Practice address
15 SW Everett Mall Way
Ste G
Everett, WA 98204-2715
Phone
(425) 355-5222
Fax
(425) 355-5231
NPI assigned
Aug 6, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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 PT60284835 WA Primary

Addresses

Primary practice location

15 SW Everett Mall Way
Ste G
Everett, WA 98204-2715

Mailing address

2610 122ND PL SE
Everett, WA 98208-6295
Phone (360) 471-1919

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address evtmanager@thinkvida.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121203000363 WA Practitioner - Physical Therapist in Private Practice 5193977874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Functional Health Consulting LLCGroup PAC ID 1759560709, 36 clinicians

Practice addresses (Care Compare)

606 120TH Ave NE
Suite D100
Bellevue, WA 98005-3026
Phone (425) 688-0223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Health Consulting, LLC Physical Therapist CurrentSince Sep 22, 2019 Accepting new patients
Functional Health Consulting, LLC CurrentSince Sep 22, 2019 Accepting new patients
Functional Health Consulting, LLC Current Accepting new patients

Locations

606 120th Ave NE
Ste D100
Bellevue, WA 98005
Phone (425) 688-0223

15 SW Everett Mall Way
Ste G
Everett, WA 98204
Phone (425) 355-5222

2014 E Madison St
Ste 100
Seattle, WA 98122
Phone (206) 726-9551

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": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1891042180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 122ND PL SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086295",
            "telephone_number": "360-471-1919",
            "fax_number": "425-355-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SW EVERETT MALL WAY",
            "address_2": "STE G",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982042715",
            "telephone_number": "425-355-5222",
            "fax_number": "425-355-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTERAKOPOULOS",
        "first_name": "CHRISTOPHER",
        "credential": "DPT, FAFS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-06",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60284835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "evtmanager@thinkvida.com",
            "affiliation": "N",
            "address_1": "15 SW Everett Mall Way",
            "address_2": "STE G",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982042715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jan 22, 2020; 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.