Individual provider Active NPI

Abigail Klinkenberg

  • Physical Therapist
  • Kent, WA
National Provider Identifier
1942977228
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
13106 SE 240TH St
Kent, WA 98031-9210
Phone
(253) 631-1933
NPI assigned
Aug 25, 2021
Last updated
Aug 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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 NU Primary

Addresses

Primary practice location

13106 SE 240TH St
Kent, WA 98031-9210

Mailing address

26837 Maple Valley Black Diamond Rd SE Ste 200
Maple Valley, WA 98038-9917

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211005000712 WA Practitioner - Physical Therapist in Private Practice 1355749409 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hidef Seattle,LLCGroup PAC ID 1850775917, 22 clinicians

Practice addresses (Care Compare)

332 Burnett Ave S
Renton, WA 98057-2505
Phone (206) 693-9929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Sports & Spine Physical Therapy - Maple Valley PS CurrentSince May 10, 2022 Accepting new patients
Hidef Seattle,LLC CurrentSince Apr 28, 2024 Accepting new patients
520 Physical Therapy, LLC Physical Therapist PastSince May 16, 2021 Accepting new patients

Locations

22443 SE 240th St
Ste 201
Maple Valley, WA 98038
Phone (425) 432-1671

332 Burnett Ave S
Renton, WA 98057
Phone (206) 693-9929

2211 5th Ave
Seattle, WA 98121
Phone (206) 693-9929

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, 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": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1942977228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26837 MAPLE VALLEY BLACK DIAMOND RD SE STE 200",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980389917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13106 SE 240TH ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980319210",
            "telephone_number": "253-631-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINKENBERG",
        "first_name": "ABIGAIL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.