Andrew M Bacha IV, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

62944 Issued in OR

Practice address

2780 E Barnett Rd Ste 200
Medford, OR 97504

Phone

(541) 779-6250

Fax

(541) 772-2531

NPI assigned

Aug 13, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Everfit Performance and Rehab LLC

  • Physical Therapist
  • Jacksonville, FL
  • NPI 1477498624

  FL

  Medicare reassignment
• Florida Luna Care Physical Therapy LLC

  • Physical Therapist
  • Jacksonville, FL
  • NPI 1114542032
  NPD
• Cottage Grove Physical Therapy Services, Inc

  • Physical Therapist
  • Cottage Grove, OR
  • NPI 1407847999
  NPD (past)
• Avamere Outpatient Services, LLC

  • Physical Therapist
  • Bothell, WA
  • NPI 1710151311
  NPD (past)
• Rehabcare Group East, LLC

  • Rehabilitation Clinic/Center
  • Shalimar, FL
  • NPI 1407382278
  NPD (past)

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1043799778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 E BARNETT RD STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048674",
            "telephone_number": "541-779-6250",
            "fax_number": "541-772-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 E BARNETT RD STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "541-779-6250",
            "fax_number": "541-772-2531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Elzora St",
            "address_purpose": "LOCATION",
            "city": "Milton Freewater",
            "state": "OR",
            "postal_code": "978629454",
            "country_code": "US",
            "telephone_number": "541-938-3318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACHA",
        "first_name": "ANDREW",
        "middle_name": "M",
        "name_suffix": "IV",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-13",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elias Ayala
• Shelby Ayles
• Robert Babek, PT
• Sara Beth Babek, O.D.
• Toni Anne Baca, FNP
• Rachel Bachman
• Jason Backus, DDS
• Natalie Bacon
• Christia Bactista
• Arianna Badizadegan, M.S.

• All providers in Medford, OR
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; 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.