Timothy Michael Mansour, DPT
NPI 1629402052ActiveIndividual· Physical Therapist· Port Ludlow, WA
Physical Therapist (DPT) with Active Life Physical Therapy LLC, practicing in Port Ludlow, Washington. Medicare paid $148,449 for services to 291 patients in 2024.
Overview
| NPI | 1629402052 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DPT |
| Sole proprietor | No |
| NPI issued | Aug 21, 2013 |
| Last updated in NPPES | Feb 13, 2014 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 60401257 | WA |
| Physical Therapist | 225100000X | 60311 | OR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (WA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 291 |
|---|---|
| Services billed | 6,440 across 12 procedure codes |
| Paid by Medicare | $148,449 |
Education and affiliations
| Graduation year | 2013 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Active Life Physical Therapy LLCPort Ludlow, WA · 2 clinicians
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