Jessica Ann Pare, MPT, OCS

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT00009591 Issued in WA

Practice address

510 8TH Ave NE Ste 340
Issaquah, WA 98029-5449

Phone

(425) 313-3051

Fax

(425) 313-3055

NPI assigned

Nov 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Jessica Ann Shattuck Former name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1023170313
  Medicare reassignment Care Compare group NPD
• Lake Washington Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Kirkland, WA
  • NPI 1770894990

  Physical Therapist

  Medicare reassignment NPD
• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Renton, WA
  • NPI 1235091463
  NPD
• Proliance Surgeons, Inc., P.S.

  • Physical Therapist
  • Bellevue, WA
  • NPI 1831138783
  NPD

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1992875314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 320",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295436",
            "telephone_number": "425-313-3051",
            "fax_number": "425-625-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 340",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295449",
            "telephone_number": "425-313-3051",
            "fax_number": "425-313-3055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1750 112th Ave NE",
            "address_2": "Suite E-175",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980043752",
            "country_code": "US",
            "telephone_number": "425-289-0381",
            "fax_number": "425-289-0387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARE",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "MPT, OCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009591",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "WA",
            "license": "PT00009591",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WA",
            "license": "PT00009591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024073",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SHATTUCK",
            "middle_name": "ANN",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mallika Ponnappa Palecanda
• Gena Palm
• Brenda Lee Palmiotto, PT
• Alexander Lite Pan, MD
• Alexandra Lyn Panos
• Sung Eun Park, MD
• Catyann Ikuko Parker, PT, DPT
• Xylie Parker, OTR/L
• John William Parmelee, DPM
• Jordan Parrick, L.M.P

• Orthopedic Physical Therapist in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Orthopedic Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.