Individual provider Active NPI

Joseph Pho, DPT

  • Physical Therapist
  • Gresham, OR
National Provider Identifier
1265197206
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
64271 Issued in OR
Practice address
24076 SE Stark St Ste 200
Gresham, OR 97030-3376
Phone
(503) 491-1666
NPI assigned
Nov 4, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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 64271 OR Primary

Addresses

Primary practice location

24076 SE Stark St Ste 200
Gresham, OR 97030-3376

Mailing address

24076 SE Stark St Ste 200
Gresham, OR 97030-3376
Phone (503) 491-1666

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220204001960 OR Practitioner - Physical Therapist in Private Practice 7810380326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapydia IncGroup PAC ID 2264678226, 35 clinicians

Practice addresses (Care Compare)

15000 SW Barrows Rd
Suite 201
Beaverton, OR 97007-8778
Phone (971) 930-4433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Therapydia, Inc. Physical Therapist CurrentSince Apr 24, 2023 Accepting new patients
Gresham Sportscare CurrentSince Sep 17, 2021 Accepting new patients
Therapydia, Inc. Physical Therapist CurrentSince Apr 24, 2023 Accepting new patients

Locations

15000 SW Barrows Rd
Ste 201
Beaverton, OR 97007
Phone (971) 257-5663

24076 SE Stark St
Ste 200
Gresham, OR 97030
Phone (503) 491-1666

2808 E Burnside St
Portland, OR 97214
Phone (503) 477-4802

Organizations & group practices 3

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": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1265197206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST STE 200",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303376",
            "telephone_number": "503-491-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST STE 200",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303376",
            "telephone_number": "503-491-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHO",
        "first_name": "JOSEPH",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; 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.