Active NPI
Angelina Marie Ciavarella, PT
- Neurology Physical Therapist
- Portland, OR
National Provider Identifier
1023397577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physical Therapist
- License
- 62593
- Practice address
- 3303 SW Bond Ave
Portland, OR 97239-4501 - Phone
- (503) 494-3151
- NPI assigned
- Aug 15, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 23764 | MD | |
| Neurology Physical Therapist | 2251N0400X | 62593 | OR | Primary |
Addresses
Primary practice location
3303 SW Bond Ave
Portland, OR 97239-4501
Mailing address
3303 SW Bond Ave
Portland, OR 97239-4501
Phone (503) 494-3151
Other practice location 1
707 N Broadway
Kennedy Krieger Institute
Baltimore, MD 21205-1832
Phone (443) 923-9400
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | n/a | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23764 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589414400000",
"number": "1023397577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3303 SW BOND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394501",
"telephone_number": "503-494-3151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3303 SW BOND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394501",
"telephone_number": "503-494-3151"
}
],
"practiceLocations": [
{
"address_1": "707 N Broadway",
"address_2": "Kennedy Krieger Institute",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212051832",
"country_code": "US",
"telephone_number": "443-923-9400",
"fax_number": "443-923-9405",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CIAVARELLA",
"first_name": "ANGELINA",
"middle_name": "MARIE",
"name_prefix": "Miss",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-15",
"last_updated": "2020-05-14",
"certification_date": "2020-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "23764",
"primary": false
},
{
"code": "2251N0400X",
"taxonomy_group": "",
"desc": "Physical Therapist, Neurology",
"state": "OR",
"license": "62593",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "n/a",
"affiliation": "N",
"endpointDescription": "n/a",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "n/a",
"address_1": "3303 SW Bond Ave",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972394501",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.