Individual provider Active NPI

Travis Michael Obermire, DPT

  • Physical Therapist
  • Corvallis, OR
National Provider Identifier
1013237718
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
61656 Issued in OR
Practice address
845 SW 30TH St
Corvallis, OR 97331-8629
Phone
(541) 768-7700
NPI assigned
Jun 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 2318PT MT
Physical Therapist 225100000X 61656 OR Primary

Addresses

Primary practice location

845 SW 30TH St
Corvallis, OR 97331-8629

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

5000 Blue Mountain Rd
Missoula, MT 59804-9213
Phone (406) 251-2323

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tobermire129105@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160718000138 OR Practitioner - Physical Therapist in Private Practice 0042502791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Samaritan Hospital CorvallisGroup PAC ID 1557270725, 372 clinicians

Practice addresses (Care Compare)

845 SW 30TH St
Corvallis, OR 97331-8629
Phone (541) 768-7700

Merit-based Incentive Payment System (MIPS)

Final score
91.14 of 100Reported as group
Quality
85.78
Promoting interoperability
100
Improvement activities
40
Cost
78.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61656ORMDPhysical Therapist
2318PTMTMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Corvallis CurrentSince May 10, 2016 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince May 10, 2016 Accepting new patients

Locations

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

845 SW 30th St
Corvallis, OR 97331
Phone (541) 768-7700

Networks

  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

  • Direct secure messaging: tobermire129105@samhealth.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1013237718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 SW 30TH ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973318629",
            "telephone_number": "541-768-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 Blue Mountain Rd",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598049213",
            "country_code": "US",
            "telephone_number": "406-251-2323",
            "fax_number": "406-251-3332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBERMIRE",
        "first_name": "TRAVIS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-03",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MT",
            "license": "2318PT",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "61656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tobermire129105@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "845 SW 30th St",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973318629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.