Active NPI
Jesus Rio-Calderon, PTA
- Physical Therapy Assistant
- Forest Grove, OR
National Provider Identifier
1124049036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 8394
- Practice address
- 2333 Pacific Avenue
Forest Grove, OR 97116 - Phone
- (503) 359-6145
- Fax
- (503) 359-6919
- NPI assigned
- Jul 23, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 8394 | OR | Primary |
Addresses
Primary practice location
2333 Pacific Avenue
Forest Grove, OR 97116
Mailing address
1315 Kingwood St
Forest Grove, OR 97116
Phone (503) 359-0247
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8394 | OR | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tuality Healthcare | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatric Hospital
- Hillsboro, OR
- NPI 1073817714
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124049036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1315 KINGWOOD ST",
"city": "FOREST GROVE",
"state": "OR",
"postal_code": "97116",
"telephone_number": "503-359-0247",
"fax_number": "503-359-6919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2333 PACIFIC AVENUE",
"city": "FOREST GROVE",
"state": "OR",
"postal_code": "97116",
"telephone_number": "503-359-6145",
"fax_number": "503-359-6919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIO-CALDERON",
"first_name": "JESUS",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OR",
"license": "8394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Grove, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.