Individual provider Active NPI

Frederique Teotonio, DC

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1992551428
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
61500150 Issued in WA
Practice address
4122 Factoria Blvd SE Ste 202
Bellevue, WA 98006-5259
Phone
(425) 590-9158
NPI assigned
Apr 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 61500150 WA Primary

Addresses

Primary practice location

4122 Factoria Blvd SE Ste 202
Bellevue, WA 98006-5259

Mailing address

9432 116TH Ave NE
Kirkland, WA 98033-5108
Phone (425) 495-6043

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241112000744 WA Practitioner - Chiropractic 9436683570 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61500150WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cummins Chiropractic and Wellness PLLC Chiropractor CurrentSince Sep 8, 2024 Accepting new patients

Locations

4122 Factoria Blvd SE
Ste 202
Bellevue, WA 98006
Phone (425) 590-9158

Organizations & group practices 1

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": "1714003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1992551428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9432 116TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980335108",
            "telephone_number": "425-495-6043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 FACTORIA BLVD SE STE 202",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980065259",
            "telephone_number": "425-590-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEOTONIO",
        "first_name": "FREDERIQUE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "61500150",
            "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 Apr 25, 2024; 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.