Individual provider Active NPI

Andrea B Gomez, PT, DPT

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1023970761
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
63247 Issued in OR
Practice address
300 N Graham St Ste 430
Portland, OR 97227-1667
Phone
(503) 413-1500
NPI assigned
Dec 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 63247 OR Primary

Addresses

Primary practice location

300 N Graham St Ste 430
Portland, OR 97227-1667

Mailing address

1616 N Alberta St
Portland, OR 97217-3604
Phone (281) 787-0301

Other practice location 1

11 NE Martin Luther King Jr Blvd Ste 202
Portland, OR 97232-3579
Phone (971) 337-6372

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260211002762 OR Practitioner - Physical Therapist in Private Practice 2567941347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emily Merollis Consulting LLCGroup PAC ID 9032443973, 10 clinicians

Practice addresses (Care Compare)

11 NE MLK Jr Blvd
Suite 202
Portland, OR 97232-3579
Phone (971) 337-6372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63247ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emily Merollis Consulting LLC CurrentSince Jan 19, 2026 Accepting new patients
Legacy Emanuel Hospital & Health Center PastSince Dec 7, 2025 Accepting new patients

Locations

11 NE Mlk Jr Blvd
Ste 202
Portland, OR 97232
Phone (971) 337-6372

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": "1764633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1023970761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 N ALBERTA ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972173604",
            "telephone_number": "281-787-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N GRAHAM ST STE 430",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271667",
            "telephone_number": "503-413-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 NE Martin Luther King Jr Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972323579",
            "country_code": "US",
            "telephone_number": "971-337-6372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "ANDREA",
        "middle_name": "B",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-02",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "63247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Dec 2, 2025; 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.