Individual provider Active NPI

Robert Mason, DPT

  • Physical Therapist
  • Corvallis, OR
National Provider Identifier
1114308046
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
61134 Issued in OR
Practice address
2350 NW Century Dr Ste 100
Corvallis, OR 97330-3495
Phone
(541) 754-1265
NPI assigned
Jun 16, 2015
Last updated
Jun 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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 61134 OR Primary

Addresses

Primary practice location

2350 NW Century Dr Ste 100
Corvallis, OR 97330-3495

Mailing address

444 NW Elks Dr
Corvallis, OR 97330-3745
Phone (541) 754-1150

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250623002156 CA Practitioner - Physical Therapist in Private Practice 8224343694 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61134ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mikla Dunning Physical Therapy Systems, PC CurrentSince Apr 5, 2025 Accepting new patients
Kime Performance Nevada LLC Past Accepting new patients

Locations

4990 Hillsdale Cir
Ste 100
El Dorado Hls, CA 95762
Phone (916) 342-4190

6700 Folsom Blvd
Sacramento, CA 95819
Phone (916) 444-3357

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1114308046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 NW ELKS DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303745",
            "telephone_number": "541-754-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 NW CENTURY DR STE 100",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303495",
            "telephone_number": "541-754-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "61134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.