Active NPI
Philip Schaub, PT, DPT
- Physical Therapist
- Portland, OR
National Provider Identifier
1053826024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 63693
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43486 | CA | MD | Dentist |
| 11993 | AZ | MD | Physical Therapist |
| 4645 | NM | MD | Physical Therapist |
| PT015341 | OH | MD | Physical Therapist |
| 63693 | OR | MD | Physical Therapist |
| CP012029T | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grays Harbor Community Hospital | Current | Accepting new patients | |
| Grays Harbor Community Hospital | Current | Accepting new patients | |
| Grays Harbor House Hospitalist | Current | 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.
-
- General Acute Care Hospital
- Aberdeen, WA
- NPI 1154378859
-
- General Acute Care Hospital
- Aberdeen, WA
- NPI 1659411486
-
- Multi-Specialty Clinic/Center
- San Diego, CA
- NPI 1952394603
Physical Therapist
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.