Individual provider Active NPI

Carol Roeder, PT

  • Physical Therapist
  • Bend, OR
National Provider Identifier
1174983415
Registry record updated Jan 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
63766 Issued in OR
Practice address
558 SE 9TH St Ste 5
Bend, OR 97702-2265
Phone
(541) 410-3428
Fax
(541) 640-5541
NPI assigned
Feb 29, 2016
Last updated
Jan 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 291240 CA
Physical Therapist 225100000X 63766 OR Primary

Addresses

Primary practice location

558 SE 9TH St Ste 5
Bend, OR 97702-2265

Mailing address

558 SE 9TH St Ste 5
Bend, OR 97702-2265
Phone (541) 410-3428

Other practice location 1

909 SE 2nd St Ste B
Bend, OR 97702-1756
Phone (541) 410-3428

Other names 1

  • Carol Schatz Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200819002118 OR Practitioner - Physical Therapist in Private Practice 9234435173 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osprey Physical Therapy and Sports Medicine LLCGroup PAC ID 3971913609, 5 clinicians

Practice addresses (Care Compare)

558 SE 9TH St
Suite 5
Bend, OR 97702-2265
Phone (541) 647-7332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63766ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Associates Inc Physical Therapist CurrentSince Aug 1, 2020 Accepting new patients
Osprey Physical Therapy and Sports Medicine, LLC. Physical Therapist CurrentSince Oct 9, 2020 Accepting new patients
Therapeutic Associates, Inc Physical Therapist CurrentSince Aug 1, 2020 Accepting new patients
Therapeutic Associates Inc Physical Therapist Current Accepting new patients

Locations

155 SW Century Dr
Ste 110
Bend, OR 97702
Phone (541) 647-7332

558 SE 9th St
Ste 5
Bend, OR 97702
Phone (541) 410-3428

61615 Athletic Club Dr
Bend, OR 97702
Phone (541) 382-7890

909 SE 2nd St
Ste B
Bend, OR 97702
Phone (541) 410-3428

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

Organizations & group practices 4

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": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737158400000",
    "number": "1174983415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 SE 9TH ST STE 5",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022265",
            "telephone_number": "541-410-3428",
            "fax_number": "541-640-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 SE 9TH ST STE 5",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022265",
            "telephone_number": "541-410-3428",
            "fax_number": "541-640-5541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 SE 2nd St Ste B",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977021756",
            "country_code": "US",
            "telephone_number": "541-410-3428",
            "fax_number": "541-640-5541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROEDER",
        "first_name": "CAROL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-29",
        "last_updated": "2025-01-18",
        "certification_date": "2025-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "291240",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "63766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "SCHATZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jan 18, 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.