Individual provider Active NPI

August C Sivak, DPT

  • Physical Therapist
  • Spokane, WA
National Provider Identifier
1912422627
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60768112 Issued in WA
Practice address
730 N Hamilton St
Spokane, WA 99202-2045
Phone
(509) 458-7686
Fax
(509) 458-6611
NPI assigned
Aug 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 PT60768112 WA Primary

Addresses

Primary practice location

730 N Hamilton St
Spokane, WA 99202-2045

Mailing address

730 N Hamilton St
Spokane, WA 99202-2045
Phone (509) 458-7686

Other identifiers 1

IdentifierTypeStateIssuer
PT60768112OtherWAPROFESSIONAL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170828002030 WA Practitioner - Physical Therapist in Private Practice 0446522304 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Luna Care Physical Therapy LLCGroup PAC ID 7416283817, 161 clinicians

Practice addresses (Care Compare)

Bellevue, WA 98006
Phone (866) 525-3175

730 N Hamilton St
Spokane, WA 99202-2045
Phone (509) 458-7686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60768112WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Luna Care Physical Therapy LLC Physical Therapist CurrentSince Mar 21, 2024 Accepting new patients

Locations

13555 SE 36th St
Ste 100
Bellevue, WA 98006

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1912422627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 N HAMILTON ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022045",
            "telephone_number": "509-458-7686",
            "fax_number": "509-458-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 N HAMILTON ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022045",
            "telephone_number": "509-458-7686",
            "fax_number": "509-458-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVAK",
        "first_name": "AUGUST",
        "middle_name": "C",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60768112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "PT60768112",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.