Active NPI
Neil Bastian, MS, PT
- Physical Therapist
- Lake Oswego, OR
National Provider Identifier
1164580999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2021
- Practice address
- 870 5TH St
Lake Oswego, OR 97034-2312 - Phone
- (503) 697-0542
- Fax
- (503) 697-4895
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 Therapist | 225100000X | 2021 | OR | Primary |
Addresses
Primary practice location
870 5TH St
Lake Oswego, OR 97034-2312
Mailing address
870 5TH St
Lake Oswego, OR 97034-2312
Phone (503) 697-0542
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191283200000",
"number": "1164580999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "870 5TH ST",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970342312",
"telephone_number": "503-697-0542",
"fax_number": "503-697-4895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "870 5TH ST",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970342312",
"telephone_number": "503-697-0542",
"fax_number": "503-697-4895"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASTIAN",
"first_name": "NEIL",
"name_prefix": "Mr.",
"credential": "MS, PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2007-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "2021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Oswego, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.