KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC – Physical Therapist, NPI 1912902347

KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC is a healthcare provider. based in Silverdale, Washington. specializing in Physical Therapist. The NPI Number for KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC is 1912902347

Main info

Organization
Name
KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC
NPI
1912902347
Phone
(360) 598-3764
Address
2400 NW MYHRE RD STE 101
Authorized Official
SUMMER ZUMWALT HRD
Enumeration Date
13 June 2005
Last Update Date
10 May 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness75
Years active:20State licenses:0Digital endpointsOther names

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Provider Addresses for KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC

  • Northwest Myhre Road, Silverdale, Kitsap County, Washington, 98383, United States

    SILVERDALE, WA 983837672

    Phone: (360) 598-3764

    Fax: (360) 598-3282

    Type: Mailing

  • 19319 7th Ave NE

    Ste 100

    Poulsbo, WA 983707442

    Phone: (360) 598-3764

    Fax: (360) 598-3282

    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: 2003-12-11

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
O20031211000242OClinic/Group 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98383)

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Reviews

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Frequently asked questions

What unique ID ties claims to KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC?
NPI 1912902347 is assigned to KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC under the national enumeration system.
Does this profile mean KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC is currently active?
Yes — KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC appears active in the national provider directory.
Can you summarize KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC's specialty in plain language?
Clinically, the directory lists KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC with Physical Therapist. Clinical services aligned with this taxonomy classification.
Where is KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC's primary listing?
We display Silverdale, Washington because that is what the record indicates for KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC.
Is KITSAP PHYSICAL THERAPY AND SPORTS CLINIC PS INC a real provider?
This page reflects official NPPES data for NPI 1912902347. Always confirm identity and privileges with the practice and licensing boards.

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