Individual provider Active NPI

Ronald I Mil, OT

  • Occupational Therapist
  • Portland, OR
National Provider Identifier
1053542183
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1057982 Issued in OR
Practice address
6410 NE Halsey St
Portland, OR 97213-4742
Phone
(971) 337-5567
Fax
(971) 337-5567
NPI assigned
Aug 6, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1057982 OR Primary

Addresses

Primary practice location

6410 NE Halsey St
Portland, OR 97213-4742

Mailing address

6410 NE Halsey St
Portland, OR 97213-4742
Phone (971) 337-5567

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250117001942 OR Practitioner - Occupational Therapist in Private Practice 6305375411 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Select Rehabilitation, LLC Occupational Therapist CurrentSince Dec 27, 2024 Accepting new patients

Locations

1010 NE Purcell Blvd
Bend, OR 97701
Phone (541) 318-6042

9000 SW 91st Ave
Tigard, OR 97223
Phone (503) 445-4363

18325 SW Pacific Hwy
Tualatin, OR 97062
Phone (503) 925-0544

17950 SW 115th Ave
Tualatin, OR 97062
Phone (503) 692-1748

Organizations & group practices 1

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": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1053542183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 NE HALSEY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972134742",
            "telephone_number": "971-337-5567",
            "fax_number": "971-337-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 NE HALSEY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972134742",
            "telephone_number": "971-337-5567",
            "fax_number": "971-337-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIL",
        "first_name": "RONALD",
        "middle_name": "I",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-06",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "1057982",
            "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 26, 2024; 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.