Active NPI
Matthew Nervino
- Physical Therapist
- Kirkland, WA
National Provider Identifier
1902355365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 60669897
- Practice address
- 12910 Totem Lake Blvd NE Ste 105
Kirkland, WA 98034-2901 - Phone
- (425) 823-8631
- NPI assigned
- Sep 27, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 60669897 | WA | Primary |
Addresses
Primary practice location
12910 Totem Lake Blvd NE Ste 105
Kirkland, WA 98034-2901
Mailing address
10832 Forbes Creek Dr
U306
Kirkland, WA 98033-3817
Phone (831) 383-8311
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60669897 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474934400000",
"number": "1902355365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10832 FORBES CREEK DR",
"address_2": "U306",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980333817",
"telephone_number": "831-383-8311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12910 TOTEM LAKE BLVD NE STE 105",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980342901",
"telephone_number": "425-823-8631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NERVINO",
"first_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-27",
"last_updated": "2016-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "60669897",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.