Individual provider Active NPI

Eli Zygmuntowicz, DPT

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1962633826
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60095182 Issued in WA
Practice address
3800 Woodland Park Ave N Ste 100
Seattle, WA 98103-7943
Phone
(206) 284-2396
Fax
(206) 547-9286
NPI assigned
Jul 27, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 PT60095182 WA Primary

Addresses

Primary practice location

3800 Woodland Park Ave N Ste 100
Seattle, WA 98103-7943

Mailing address

3800 Woodland Park Ave N Ste 100
Seattle, WA 98103-7943
Phone (206) 284-2396

Other practice location 1

1201 3rd Ave Ste 450
Seattle, WA 98101-3000
Phone (206) 447-2220

Other practice location 2

109 SE 101st Ave
Vancouver, WA 98664-3907
Phone (206) 284-2396

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091117000706 WA Practitioner - Physical Therapist in Private Practice 1951449610 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60095182WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Physical Therapy PLLC CurrentSince Aug 1, 2016 Accepting new patients

Locations

3800 Woodland Park Ave N
Ste 100
Seattle, WA 98103
Phone (206) 284-2396

109 SE 101st Ave
Vancouver, WA 98664
Phone (360) 256-6748

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": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1962633826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 WOODLAND PARK AVE N STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981037943",
            "telephone_number": "206-284-2396",
            "fax_number": "206-547-9286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 WOODLAND PARK AVE N STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981037943",
            "telephone_number": "206-284-2396",
            "fax_number": "206-547-9286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 3rd Ave Ste 450",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981013000",
            "country_code": "US",
            "telephone_number": "206-447-2220",
            "fax_number": "206-447-2228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 SE 101st Ave",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986643907",
            "country_code": "US",
            "telephone_number": "206-284-2396",
            "fax_number": "206-547-9286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZYGMUNTOWICZ",
        "first_name": "ELI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60095182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.