Organization Active NPI

Sisters Physical Therapy, LLC.

  • Physical Therapy Clinic/Center
  • Sisters, OR
National Provider Identifier
1053197947
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SISTERS PHYSICAL THERAPY, LLC.
Practice address
100 Lundgren Mill Dr.
#103
Sisters, OR 97759
Phone
(503) 487-7025
NPI assigned
Sep 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Authorized official

Name
Dr. Paul Daniel Erlebach, DPTNPI 1821672221
Title
Owner
Phone
(503) 487-7025

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

100 Lundgren Mill Dr.
#103
Sisters, OR 97759

Mailing address

100 Lundgren Mill Dr.
#103
Sisters, OR 97759
Phone (503) 487-7025

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240301001219 OR Part B Supplier - Clinic/Group Practice 3476998360 Receives reassigned benefits from 1 practitioner
Practice locations: Sisters, OR

National Provider Directory

National Provider Directory

Locations

411 E Carpenter Ln
Sisters, OR 97759
Phone (458) 256-0627

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1053197947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LUNDGREN MILL DR.",
            "address_2": "#103",
            "city": "SISTERS",
            "state": "OR",
            "postal_code": "97759",
            "telephone_number": "503-487-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LUNDGREN MILL DR.",
            "address_2": "#103",
            "city": "SISTERS",
            "state": "OR",
            "postal_code": "97759",
            "telephone_number": "503-487-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISTERS PHYSICAL THERAPY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "ERLEBACH",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-487-7025",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sisters, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.