Proliance Sports Therapy and Rehab of Issaquah – Physical Therapist, NPI 1083752042
Physical Therapist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Proliance Sports Therapy and Rehab of Issaquah
7726 Center Blvd SE Ste 220
Snoqualmie, WA 980658753
Phone: (425) 313-3055
Fax: (425) 313-3051
Type: Location
510 8TH AVE NE STE 320
ISSAQUAH, WA 980295436
Phone: (425) 313-3055
Fax: (425) 313-3051
Type: Mailing
510 8TH AVE NE STE 340
ISSAQUAH, WA 980295449
Phone: (425) 313-3051
Fax: (425) 313-3051
Type: Location
Metropolitan Deli & Cafe, 805, Madison Street, Central Business District, First Hill, Seattle, King County, Washington, 98104, United States
SUITE 901
SEATTLE, WA 981041172
Phone: (206) 264-8100
Fax: (206) 264-8689
Type: Mailing
Proliance Highlands Surgery Center, 510, 8th Avenue Northeast, Discovery West, Issaquah, King County, Washington, 98029, United States
SUITE 340
ISSAQUAH, WA 980295436
Phone: (425) 313-3055
Fax: (425) 313-3051
Type: Location
1200 112th Ave NE Ste C260
Bellevue, WA 980043746
Phone: (425) 313-3055
Fax: (425) 313-3051
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: 2011-06-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-07-31 (676 days ago).
Enrollment records
1
Earliest due date
2024-07-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20110617000622 | O | Physician - General Practice | WA | 2024-07-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98065)
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