Individual provider Active NPI

James M Lee, DPT

  • Physical Therapist
  • Everett, WA
National Provider Identifier
1982011128
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60462380 Issued in WA
Practice address
10821 19TH Ave SE Ste 102
Everett, WA 98208
Phone
(425) 225-5865
Fax
(425) 948-6643
NPI assigned
Jul 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 42590 CA
Physical Therapist 225100000X PT60462380 WA Primary

Addresses

Primary practice location

10821 19TH Ave SE Ste 102
Everett, WA 98208

Mailing address

730 N Hamilton St
Spokane, WA 99202-2045
Phone (425) 225-5865

Other practice location 1

5420 Barnes Ave NW
Seattle, WA 98107
Phone (206) 789-7975

Other identifiers 3

IdentifierTypeStateIssuer
PT60462380OtherWAPHYSICAL THERAPIST LICENSE
PT60462380OtherWAWASHINGTON STATE DEPARTMENT OF LICENSING
PT42590OtherCASTATE OF CALIFORNIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140905002118 WA Practitioner - Physical Therapist in Private Practice 7416175369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PNW Physical Therapy LLCGroup PAC ID 5890029755, 5 clinicians

Practice addresses (Care Compare)

10821 19TH Ave SE
Suite 102
Everett, WA 98208-5103
Phone (425) 225-5865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 42590CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PNW Physical Therapy, LLC Physical Therapist CurrentSince Jan 15, 2019 Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

10821 19th Ave SE
Everett, WA 98208
Phone (425) 337-7000

10821 19th Ave SE
Ste 102
Everett, WA 98208
Phone (425) 225-5865

730 N Hamilton St
Spokane, WA 99202
Phone (509) 458-7686

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1982011128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 N HAMILTON ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022045",
            "telephone_number": "425-225-5865",
            "fax_number": "425-948-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10821 19TH AVE SE STE 102",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98208",
            "telephone_number": "425-225-5865",
            "fax_number": "425-948-6643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5420 Barnes Ave NW",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98107",
            "country_code": "US",
            "telephone_number": "206-789-7975",
            "fax_number": "206-782-6177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JAMES",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-21",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 42590",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60462380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST LICENSE",
            "identifier": "PT60462380",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF LICENSING",
            "identifier": "PT60462380",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA",
            "identifier": "PT42590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.