Anthony Michael Agostini

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

64614 Issued in OR

Practice address

3871 Fairview Industrial Dr SE Ste 120
Salem, OR 97302-1172

Phone

(503) 990-6393

NPI assigned

Aug 3, 2022

Last updated

Aug 3, 2022By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sportscare Physical Therapy @ Cornell, LLC

  • Durable Medical Equipment & Medical Supplies
  • Tigard, OR
  • NPI 1255190153
  NPD
• Sportscare Physical Therapy @ Cornell, LLC

  • Physical Therapy Clinic/Center
  • Beaverton, OR
  • NPI 1649534793
  NPD

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1053048694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3871 FAIRVIEW INDUSTRIAL DR SE STE 120",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3871 FAIRVIEW INDUSTRIAL DR SE STE 120",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021172",
            "telephone_number": "503-990-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOSTINI",
        "first_name": "ANTHONY",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Afshar
• Darioush Afshar
• Vimal Mohun Aga
• Chinar Agarwal, M.D.
• Alison Renee Agnetta, MD
• Jason Aguayo, LMT
• Kymell Yarice Agudo Garcia, MS, CCC-SLP
• Monica Araceli Aguiar, BSN RN
• Andres Adalbeto Aguilar Jr., LD
• Isai Simon Aguilar

• Physical Therapist in Salem, OR
• Providers in Salem, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.