Individual provider Active NPI

Caron M Treloar, PT

  • Physical Therapist
  • Mill Creek, WA
National Provider Identifier
1932365814
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60031910 Issued in WA
Practice address
16030 Bothell Everett Hwy
Suite 200
Mill Creek, WA 98012-1741
Phone
(425) 745-4910
Fax
(425) 338-5709
NPI assigned
Jul 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

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 PT60031910 WA Primary

Addresses

Primary practice location

16030 Bothell Everett Hwy
Suite 200
Mill Creek, WA 98012-1741

Mailing address

16030 Bothell Everett Hwy
Suite 200
Mill Creek, WA 98012-1741
Phone (425) 745-4910

Other identifiers 2

IdentifierTypeStateIssuer
0238225OtherWADEPT. OF LABOR & INDUSTRY
5814TROtherWAREGENCE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080822000479 WA Practitioner - Physical Therapist in Private Practice 7416022611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Washington Physical Therapy LLCGroup PAC ID 3476679812, 54 clinicians

Practice addresses (Care Compare)

6704 NE 181St St
Suite 101
Kenmore, WA 98028-4890
Phone (425) 419-4363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60031910WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Washington Physical Therapy LLC Physical Therapist CurrentSince Dec 13, 2022 Accepting new patients

Locations

6704 NE 181st St
Ste 101
Kenmore, WA 98028
Phone (425) 246-9799

209 Kirkland Ave
Kirkland, WA 98033
Phone (425) 629-3502

Organizations & group practices 1

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": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231718400000",
    "number": "1932365814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16030 BOTHELL EVERETT HWY",
            "address_2": "SUITE 200",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121741",
            "telephone_number": "425-745-4910",
            "fax_number": "425-338-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16030 BOTHELL EVERETT HWY",
            "address_2": "SUITE 200",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121741",
            "telephone_number": "425-745-4910",
            "fax_number": "425-338-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRELOAR",
        "first_name": "CARON",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-31",
        "last_updated": "2009-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60031910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF LABOR & INDUSTRY",
            "identifier": "0238225",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "5814TR",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; 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.