Individual provider Active NPI

Timothy I Gross, PT

  • Physical Therapist
  • Bend, OR
National Provider Identifier
1073971867
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
61543 Issued in OR
Practice address
20885 Egypt Dr Ste 150
Bend, OR 97701-7827
Phone
(541) 250-3020
NPI assigned
Feb 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 61543 OR Primary

Addresses

Primary practice location

20885 Egypt Dr Ste 150
Bend, OR 97701-7827

Mailing address

20757 NE Sierra Dr
Bend, OR 97701-7174
Phone (541) 250-3020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160317000422 OR Practitioner - Physical Therapist in Private Practice 4688970635 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Basecamp Physical Therapy LLC Physical Therapist Current Accepting new patients
Rebound Physical Therapy Limited Partnership Physical Therapist CurrentSince Mar 1, 2016 Accepting new patients
Rebound Physical Therapy Limited Partnership Physical Therapist CurrentSince Mar 1, 2016 Accepting new patients

Locations

805 SW Industrial Way
Ste 3
Bend, OR 97702
Phone (541) 323-5864

425 N Main St
Prineville, OR 97754
Phone (541) 416-7476

1315 NW 4th St
Apt B
Redmond, OR 97756
Phone (541) 504-2350

1717 NE 2nd St
Redmond, OR 97756
Phone (541) 332-9045

Organizations & group practices 3

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": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1073971867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20757 NE SIERRA DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017174",
            "telephone_number": "541-250-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20885 EGYPT DR STE 150",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017827",
            "telephone_number": "541-250-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "TIMOTHY",
        "middle_name": "I",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-08",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "61543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.