Individual provider Active NPI

Philip Schaub, PT, DPT

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1053826024
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
63693 Issued in OR
Practice address
1720 SW 4TH Ave Apt 413
Portland, OR 97201-5533
Phone
(614) 315-3130
NPI assigned
Dec 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4645 NM
Physical Therapist 225100000X 11993 AZ
Physical Therapist 225100000X 43486 CA
Physical Therapist 225100000X CP012029T WA
Physical Therapist 225100000X 63693 OR Primary
Physical Therapist 225100000X PT015341 OH

Addresses

Primary practice location

1720 SW 4TH Ave Apt 413
Portland, OR 97201-5533

Mailing address

1720 SW 4TH Ave Apt 413
Portland, OR 97201-5533
Phone (614) 315-3130

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250616000782 WA Practitioner - Physical Therapist in Private Practice 9032508189 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
43486CAMDDentist
11993AZMDPhysical Therapist
4645NMMDPhysical Therapist
PT015341OHMDPhysical Therapist
63693ORMDPhysical Therapist
CP012029TWAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grays Harbor Community Hospital CurrentSince Jun 1, 2025 Accepting new patients
Grays Harbor Community Hospital Current Accepting new patients
Grays Harbor House Hospitalist CurrentSince Jun 1, 2025 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist Past Accepting new patients

Locations

915 Anderson Dr
Aberdeen, WA 98520
Phone (360) 532-8330

Organizations & group practices 4

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": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1053826024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 SW 4TH AVE APT 413",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015533",
            "telephone_number": "614-315-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 SW 4TH AVE APT 413",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015533",
            "telephone_number": "614-315-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAUB",
        "first_name": "PHILIP",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-12",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "4645",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "11993",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "43486",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "CP012029T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "63693",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT015341",
            "primary": false
        }
    ],
    "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 Jul 13, 2022; 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.