Kristine Maclean-Talbot

Individual provider Active NPI Physical Therapist · Redmond, OR

NPI 1235249889 · NPPES record last updated Nov 13, 2012

Key facts

NPI
1235249889
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
450 NW Greenwood Ave
Redmond, OR 97756-1531
Phone
(542) 923-0410
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Proactive LLC (53 clinicians)

Practice addresses (Care Compare)

450 NW Greenwood Ave
Redmond, OR 97756-1531
Phone (541) 923-0410

61470 S Hwy 97
Suite 3B
Bend, OR 97702-2187
Phone (541) 508-5473

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20130821000249 OR Practitioner - Physical Therapist in Private Practice 3577706688 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Omnis Omnia Inc. Current
since Oct 1, 2017
Accepting new patients

Locations

910 SW Highway 97
Madras, OR 97741
Phone (541) 923-0410

450 NW Greenwood Ave
Redmond, OR 97756
Phone (541) 923-0410

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Yes

Addresses

Primary practice location

450 NW Greenwood Ave
Redmond, OR 97756-1531

Mailing address

1144 NW Stannium Rd
Bend, OR 97701-2141
Phone (207) 299-7796

Other identifiers

IdentifierTypeStateIssuer
5750OtherORLICENSE #
PT2928OtherMELICENSE #

Other providers in Redmond, OR

All providers in Redmond, OR · Physical Therapist in Oregon

Sources for this page

Verify at the official NPI Registry.