NPIMap

Organization Active NPI

Mosaic Rehabilitation Inc.

  • Specialist
  • Bellevue, WA
National Provider Identifier
1972790947
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT00010516 Issued in WA
Legal business name
MOSAIC REHABILITATION INC.
Practice address
2445 140TH Ave NE
Suite B-105
Bellevue, WA 98005-1879
Phone
(425) 644-6328
Fax
(425) 644-6295
NPI assigned
Oct 3, 2007
Last updated
Oct 3, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Andrea Lupul Sims, SLP
Title
President
Phone
(425) 644-6328

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT00010516 WA Primary

Addresses

Primary practice location

2445 140TH Ave NE
Suite B-105
Bellevue, WA 98005-1879

Mailing address

2445 140TH Ave NE
Suite B-105
Bellevue, WA 98005-1879
Phone (425) 644-6328

National Provider Directory

National Provider Directory
Tax ID family
Mosaic Rehabilitation Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2445 140th Ave NE
Ste B105
Bellevue, WA 98005
Phone (425) 644-6328

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1972790947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2445 140TH AVE NE",
            "address_2": "SUITE B-105",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051879",
            "telephone_number": "425-644-6328",
            "fax_number": "425-644-6295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 140TH AVE NE",
            "address_2": "SUITE B-105",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051879",
            "telephone_number": "425-644-6328",
            "fax_number": "425-644-6295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC REHABILITATION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-03",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "LUPUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-644-6328",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "PT00010516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.