Lynne Marie Pedersen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

9828 East Burnside
Suite #250
Portland, OR 97216-2365

Phone

(503) 254-3424

Fax

(503) 254-3635

NPI assigned

Jan 8, 2007

Last updated

May 9, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Proactive LLCGroup PAC ID 7315218708, 53 clinicians

Oregon Luna Care Physical Therapy LLCGroup PAC ID 5597178087, 51 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• New Proactive LLC

  dba ProActive Physical Therapy

  • Physical Therapy Clinic/Center
  • Oregon City, OR
  • NPI 1396273199

  Physical Therapist, WA

  Medicare reassignment Care Compare group NPD
• Oregon Luna Care Physical Therapy LLC

  • Physical Therapist
  • Hillsboro, OR
  • NPI 1891397121
  Medicare reassignment Care Compare group NPD
• Keiichi Aoyama, DC, MS

  • Chiropractor
  • Beaverton, OR
  • NPI 1730574880
  Medicare reassignment
• Dimond Physical Therapy and Performance Lab, LLC

  dba The KOR

  • Physical Therapist
  • Beaverton, OR
  • NPI 1184864365
  NPD (past)
• Erhardt Physical Therapy and Sports Medicine, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Scappoose, OR
  • NPI 1326110313
  NPD (past)
• H & P Goodell, Inc.

  dba Goodell Physical Therapy & Fitness Training

  • Physical Therapy Clinic/Center
  • Portland, OR
  • NPI 1013908169
  NPD (past)
• Pivot Health Acupuncture

  • Acupuncturist
  • Clackamas, OR
  • NPI 1184040255
  NPD (past)
• Optm Sports & Physical Therapy, Inc

  • Specialist
  • Los Gatos, CA
  • NPI 1578534194

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399593600000",
    "number": "1184772600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9828 EAST BURNSIDE",
            "address_2": "SUITE #250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162365",
            "telephone_number": "503-254-3424",
            "fax_number": "503-254-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9828 EAST BURNSIDE",
            "address_2": "SUITE #250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162365",
            "telephone_number": "503-254-3424",
            "fax_number": "503-254-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "LYNNE",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2014-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4951",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00007233",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Dale Pedersen, M.D.
• Eizabeth Michele Pedersen, LMT
• Joni Pedersen
• Katherine A. Pedersen, CADCI
• Logan Pedersen
• Susan K Pedersen, LMT
• Tyler Pedersen, LMT
• Ben Lawrence Pederson, M.D.
• Constance Eldridge Pederson, PH.D.
• Jason Pederson

• Physical Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2014; 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.