Individual provider Active NPI

Vincent Capellino, PT

  • Physical Therapist
  • Beaverton, OR
National Provider Identifier
1104381540
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
63141 Issued in OR
Practice address
1 SW Bowerman Dr # BJ1
Beaverton, OR 97005-0979
Phone
(503) 671-3962
NPI assigned
Feb 8, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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 63141 OR Primary

Addresses

Primary practice location

1 SW Bowerman Dr # BJ1
Beaverton, OR 97005-0979

Mailing address

16083 SW Upper Boones Ferry Rd Ste 300
Tigard, OR 97224-7736
Phone (503) 443-6156

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190318001263 OR Practitioner - Physical Therapist in Private Practice 7618217282 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapeutic Associates IncGroup PAC ID 0042116279, 319 clinicians
Gateway Sports Medicine and Rehabilitation PCGroup PAC ID 4385617489, 8 clinicians

Practice addresses (Care Compare)

20055 SW Pacific Hwy
Suite 110
Sherwood, OR 97140-9294
Phone (503) 625-1691

2800 SW Hocken Ave
Beaverton, OR 97005-2443
Phone (503) 500-5961

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63141ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Sports Medicine & Rehabilitation PC Physical Therapist CurrentSince Apr 14, 2025 Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Feb 8, 2019 Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Feb 8, 2019 Accepting new patients
Therapeutic Associates Inc Physical Therapist Current Accepting new patients
Pivot Health Acupuncture PastSince Jan 28, 2024 Accepting new patients
Sarah Frances Butler Fan PastSince Mar 20, 2025 Accepting new patients
Therapeutic Associates Inc Physical Therapist PastSince Mar 20, 2025 Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

2800 SW Hocken Ave
Beaverton, OR 97005
Phone (503) 500-5961

16315 SW Barrows Rd
Ste 205
Beaverton, OR 97007
Phone (503) 521-0500

8810 SE Sunnybrook Blvd
Ste 100
Clackamas, OR 97015
Phone (503) 261-1120

4734 River Rd N
Keizer, OR 97303
Phone (503) 463-4663

8028 NE Glisan St
Ste B
Portland, OR 97213
Phone (503) 253-0924

1307 NE 102nd Ave
Ste G
Portland, OR 97220
Phone (503) 253-0924

10215 SW Parkway
Ste D
Portland, OR 97225
Phone (503) 292-3583

58147 Columbia River Hwy
Ste A
Saint Helens, OR 97051
Phone (503) 397-1914

20055 SW Pacific Hwy
Ste 110
Sherwood, OR 97140
Phone (503) 625-1691

16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224
Phone (503) 443-6153

29100 SW Town Center Loop W
Ste 190
Wilsonville, OR 97070
Phone (503) 570-7600

Organizations & group practices 9

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": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1104381540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD STE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "503-443-6156",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SW BOWERMAN DR # BJ1",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970050979",
            "telephone_number": "503-671-3962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPELLINO",
        "first_name": "VINCENT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-08",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "63141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.