Individual provider Active NPI

Terri Nishimoto, P.T.

  • Physical Therapist
  • Denver, CO
National Provider Identifier
1891745998
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 2031 Issued in CO
Practice address
1601 East 19TH Ave
Suite 5500
Denver, CO 80218-1291
Phone
(720) 402-3801
Fax
(720) 402-3820
NPI assigned
May 11, 2006
Last updated
Feb 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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 PT 2031 CO Primary

Addresses

Primary practice location

1601 East 19TH Ave
Suite 5500
Denver, CO 80218-1291

Mailing address

1601 East 19TH Ave
Suite 5500
Denver, CO 80218-1291
Phone (720) 402-3801

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050106000971 CO Practitioner - Physical Therapist in Private Practice 3375591233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy of BoulderGroup PAC ID 6002882339, 19 clinicians

Practice addresses (Care Compare)

3020 Carbon PL
Suite 330
Boulder, CO 80301-6148
Phone (303) 938-1141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 2031COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy of Boulder Physical Therapist CurrentSince Jun 15, 2019 Accepting new patients

Locations

3020 Carbon Pl
Ste 330
Boulder, CO 80301
Phone (303) 938-1141

275 S Main St
Ste 201
Longmont, CO 80501
Phone (303) 682-2440

Organizations & group practices 2

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1891745998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 EAST 19TH AVE",
            "address_2": "SUITE 5500",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181291",
            "telephone_number": "720-402-3801",
            "fax_number": "720-402-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 EAST 19TH AVE",
            "address_2": "SUITE 5500",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181291",
            "telephone_number": "720-402-3801",
            "fax_number": "720-402-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIMOTO",
        "first_name": "TERRI",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PT 2031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.