Pacific Sports Rehab, Pllc is a medicare enrolled "Clinic/center - Physical Therapy" provider in Mountlake Terrace, Washington. Their current practice location is
6912 220th St Sw Ste 205, Mountlake Terrace, Washington. You can reach out to their office (for appointments etc.) via phone at
(425) 712-1987.
Pacific Sports Rehab, Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Pacific Sports Rehab, Pllc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1427770122.
Healthcare Provider's Profile
| Full Name | Pacific Sports Rehab, Pllc |
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| Type | Facility |
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| Speciality | Clinic/center - Physical Therapy |
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| Location | 6912 220th St Sw Ste 205, Mountlake Terrace, Washington |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1427770122
- Provider Enumeration Date: 09/19/2022
- Last Update Date: 04/05/2024
Medicare PECOS Information:
- PECOS PAC ID: 2264802735
- Enrollment ID: O20221227000258
Medical Identifiers
Medical identifiers for Pacific Sports Rehab, Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1427770122 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Pacific Sports Rehab, Pllc acts as a billing entity for following providers:
| Provider Name | Bryan David Simpson |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1700266673
PECOS PAC ID: 6507171022
Enrollment ID: I20150813009304 |
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| Provider Name | Natalie S Allen |
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| Provider Type | Practitioner - Occupational Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1598281933
PECOS PAC ID: 8022382977
Enrollment ID: I20170915003195 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Pacific Sports Rehab, Pllc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Pacific Sports Rehab, Pllc
6912 220th St Sw Ste 205,
Mountlake Terrace, WA 98043-2169
Ph: (425) 712-1987 | Pacific Sports Rehab, Pllc
6912 220th St Sw Ste 205,
Mountlake Terrace, WA 98043-2169
Ph: (425) 712-1987 |
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