Individual provider Active NPI

Joseph G Banach, PT

  • Physical Therapist
  • Redmond, WA
National Provider Identifier
1972565042
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
22500 NE Marketplace Dr
Suite 204
Redmond, WA 98053-2033
Phone
(425) 836-1034
Fax
(425) 836-1037
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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 Primary

Addresses

Primary practice location

22500 NE Marketplace Dr
Suite 204
Redmond, WA 98053-2033

Mailing address

1519 132ND St SE
Suite a
Everett, WA 98208-7203
Phone (425) 330-0633

Other identifiers 14

IdentifierTypeStateIssuer
2250BAOtherWAREGENCE
911745305-98053-A005OtherWATRICARE
P00353317OtherWARAILROAD MEDICARE
0232276OtherWALABOR & INDUSTRIES
G8872200OtherWAMEDICARE
7312449OtherWAAETNA
8939859OtherWAL & I CRIME VICTIMS
0275625OtherWAL&I
0192795OtherWADEPT. OF LABOR & INDUSTRY
5303BAOtherWAREGENCE BLUE SHIELD
8340622OtherWADSHS
9847BAOtherWAREGENCE BLUE SHIELD
P00473355OtherWARAILROAD MEDICARE
0693BAOtherWAREGENCE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040524000295 WA Practitioner - Physical Therapist in Private Practice 0749271179 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redmond Ridge Physical Therapy PLLCGroup PAC ID 7810075561, 13 clinicians

Practice addresses (Care Compare)

22500 NE Marketplace Dr
Suite 204
Redmond, WA 98053-2033
Phone (425) 836-1034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Mar 1, 2011 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist Current Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Mar 1, 2011 Accepting new patients
Redmond Ridge Physical Therapy PLLC Physical Therapist CurrentSince May 1, 2008 Accepting new patients
Redmond Ridge Physical Therapy PLLC CurrentSince May 1, 2008 Accepting new patients

Locations

1300 W Sam Houston Pkwy S
Ste 300
Houston, TX 77042
Phone (713) 297-7052

875 Wesley St
Ste 220
Arlington, WA 98223
Phone (425) 337-3166

4935 Lakemont Blvd SE
Ste 4
Bellevue, WA 98006
Phone (425) 956-3838

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

1519 132nd St SE
Ste A
Everett, WA 98208
Phone (425) 337-9556

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

22500 NE Marketplace Dr
Ste 204
Redmond, WA 98053
Phone (425) 836-1034

13930 NE 178th Pl
Ste 112
Woodinville, WA 98072
Phone (425) 939-2194

Organizations & group practices 5

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": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1972565042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 132ND ST SE",
            "address_2": "SUITE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982087203",
            "telephone_number": "425-330-0633",
            "fax_number": "425-338-9637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22500 NE MARKETPLACE DR",
            "address_2": "SUITE 204",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980532033",
            "telephone_number": "425-836-1034",
            "fax_number": "425-836-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANACH",
        "first_name": "JOSEPH",
        "middle_name": "G",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "2250BA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "911745305-98053-A005",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00353317",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0232276",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "G8872200",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7312449",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I CRIME VICTIMS",
            "identifier": "8939859",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0275625",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF LABOR & INDUSTRY",
            "identifier": "0192795",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "5303BA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS",
            "identifier": "8340622",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "9847BA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00473355",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "0693BA",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; 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.