LAURA MIZUMOTO (DPT) – Physical Therapist, NPI 1679984223

LAURA MIZUMOTO (DPT) is a healthcare provider. based in Lynnwood, Washington. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 60226057 (WA). The NPI Number for LAURA MIZUMOTO (DPT) is 1679984223

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
LAURA MIZUMOTO (DPT)
NPI
1679984223
Phone
(425) 776-0803
Address
4030 ALDERWOOD MALL BLVD
Enumeration Date
16 May 2014
Last Update Date
20 January 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2538583332
Graduation Year
2011 (15 years ago)
PAC ID
5193145761
Group Practice PAC ID
7012153687
Professional Enrollment ID
I20201020002459
Address ID
WA983351140GI7306XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:12State licenses:1Digital endpointsOther names

3,527 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WA

Provider Addresses for LAURA MIZUMOTO (DPT)

  • 4030 ALDERWOOD MALL BLVD

    LYNNWOOD, WA 98036

    Phone: (425) 776-0803

    Fax: (425) 776-0813

    Type: Mailing

  • 4030 Alderwood Mall Blvd

    Lynnwood, WA 98036

    Phone: (425) 776-0803

    Fax: (425) 776-0813

    Type: Location

  • 7306 STINSON AVE

    GIG HARBOR, WA 983351140

    Phone: (253) 858-3332

    Fax: (253) 858-3327

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-10-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20201020002459IPhysical Therapist In Private PracticeWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes71454$0
97530Therapy procedure using functional activities58750$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care10519$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes6835$0
97140Therapy procedure using manual technique, each 15 minutes5314$0
View full utilization report →

Insurance plans in this area (ZIP 98036)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012153687View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeWA
-WA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA

Reviews

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Frequently asked questions

What is the registry number for LAURA MIZUMOTO (DPT)?
The registry entry for LAURA MIZUMOTO (DPT) shows NPI 1679984223.
Should I treat LAURA MIZUMOTO (DPT) as an active provider?
Patients and plans typically see LAURA MIZUMOTO (DPT) as active in the national extract.
What services align with LAURA MIZUMOTO (DPT)'s listing?
LAURA MIZUMOTO (DPT)'s public classification highlights Physical Therapist. Clinical services aligned with this taxonomy classification.
What city is tied to LAURA MIZUMOTO (DPT)?
The directory associates LAURA MIZUMOTO (DPT) with Lynnwood, Washington. Check all listed addresses for suites or satellite offices.
Who maintains LAURA MIZUMOTO (DPT)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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