JACOB D HENDERSON PT, DPT
NPI 1609482553
Physical Therapist in Bonney Lake, WA
About Jacob D Henderson Pt, Dpt NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACOB D HENDERSON PT, DPT (NPI 1609482553) is an individual physical therapist in Bonney Lake, Washington, licensed in Washington (PT61095770) and active in the NPI registry since September 2020. He maintains a secondary practice location in Federal Way and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jacob D Henderson Pt, Dpt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Jacob Henderson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Bonney Lake, WA 98391
- Reassigned Medicare billing, Washington enrollment
- 7 clinicians in this Medicare group
Renton, WA 98057
- Reassigned Medicare billing, Washington enrollment
- 2,678 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 7
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 98391 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BONNEY LAKE, WA 98391
BONNEY LAKE, WA 98391
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jacob Henderson's NPI number?
The NPI number for Jacob Henderson is 1609482553. It was assigned to this individual provider in the NPPES registry on September 16, 2020.
Where is Jacob Henderson located?
Jacob Henderson practices at 21525 Hwy 410 E Ste B, Bonney Lake, WA 98391. The listed phone number is (253) 826-8520.
What is Jacob Henderson's specialty?
The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.
Is Jacob Henderson enrolled in Medicare?
Yes. Jacob Henderson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Jacob Henderson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Henderson reassigns Medicare benefits to 2 organizations: Performance Sports And Spine Physical Therapy Ps (Bonney Lake, WA) and Kaiser Foundation Health Plan Of Washington (Renton, WA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacob Henderson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jacob Henderson accept?
Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Jacob Henderson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jacob Henderson was last updated on September 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jacob D Henderson, PT, DPT · NPI 1609482553
Physical Therapist provider in Bonney Lake, Washington. Individual provider, active in the CMS NPPES registry since September 16, 2020.
## Identity
- **NPI:** 1609482553 (Entity type: Individual)
- **Enumerated:** September 16, 2020
- **Primary specialty:** Physical Therapist · taxonomy 225100000X
- **State license:** PT61095770 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 21525 HWY 410 E STE B, Bonney Lake, WA 98391-4101
- **Phone:** (253) 826-8520
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Performance Sports And Spine Physical Therapy Ps (NPI 1093957292, Bonney Lake, WA); Kaiser Foundation Health Plan Of Washington (NPI 1124264577, Renton, WA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** September 10, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1609482553) · Data from the CMS NPPES public registry.