Individual provider Active NPI

Olivia Muro, DPT

  • Physical Therapist
  • Milwaukie, OR
National Provider Identifier
1255993671
Registry record updated Jul 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4560 SE International Way Ste 100
Milwaukie, OR 97222-4628
Phone
(860) 805-4104
NPI assigned
Jul 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

4560 SE International Way Ste 100
Milwaukie, OR 97222-4628

Mailing address

4560 SE International Way Ste 100
Milwaukie, OR 97222-4628
Phone (860) 805-4104

Other practice location 1

4560 SE International Way Ste 100
Milwaukie, OR 97222-4628
Phone (860) 805-4104

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221110002977 DC Practitioner - Physical Therapist in Private Practice 2860869443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Goodwin House Home and Community Based ServicesGroup PAC ID 7214366244, 15 clinicians

Practice addresses (Care Compare)

5000 Fairbanks Ave
Alexandria, VA 22311-1246
Phone (703) 578-7195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Goodwin House Home and Community Based Services Physical Therapist CurrentSince Nov 1, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562284800000",
    "number": "1255993671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY STE 100",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972224628",
            "telephone_number": "860-805-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY STE 100",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972224628",
            "telephone_number": "860-805-4104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4560 SE International Way Ste 100",
            "address_purpose": "LOCATION",
            "city": "Milwaukie",
            "state": "OR",
            "postal_code": "972224628",
            "country_code": "US",
            "telephone_number": "860-805-4104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MURO",
        "first_name": "OLIVIA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-05",
        "last_updated": "2019-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2019; 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.