Active NPI
Patrick Clinton, PT
- Physical Therapist
- Gresham, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 61355
- Practice address
- 24076 SE Stark St
Suite 200
Gresham, OR 97030-3373 - Phone
- (503) 491-1666
- NPI assigned
- Sep 22, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 61355 | OR | Primary |
Addresses
Primary practice location
24076 SE Stark St
Suite 200
Gresham, OR 97030-3373
Mailing address
24076 SE Stark St
Suite 200
Gresham, OR 97030-3373
Phone (503) 491-1666
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151009002309 | OR | Practitioner - Physical Therapist in Private Practice | 4486962578 | Reassigns benefits to 1 organization |
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
- Sportscare Physical Therapy @ Cornell, LLC
Practice addresses (Care Compare)
16100 NW Cornell Rd
Suite 110
Beaverton, OR 97006-7369
Phone (971) 245-6663
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61355 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sportscare Physical Therapy @ Cornell, LLC | Current | Accepting new patients | |
| Sportscare Physical Therapy @ Cornell, LLC | Current | Accepting new patients | |
| Gresham Sportscare | Current | Accepting new patients |
Locations
16100 NW Cornell Rd
Ste 110
Beaverton, OR 97006
Phone (971) 245-6663
10121 SE Sunnyside Rd
Ste 208
Clackamas, OR 97015
Phone (503) 427-2956
24076 SE Stark St
Ste 200
Gresham, OR 97030
Phone (503) 491-1666
3871 Fairview Industrial Dr SE
Ste 120
Salem, OR 97302
Phone (503) 990-6393
16621 Champion Way
Ste 100
Sandy, OR 97055
Phone (503) 668-5321
Organizations & group practices 7
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.
-
- Physical Therapy Clinic/Center
- Beaverton, OR
- NPI 1649534793
OR
-
- Durable Medical Equipment & Medical Supplies
- Tigard, OR
- NPI 1255190153
-
- Durable Medical Equipment & Medical Supplies
- Portland, OR
- NPI 1417716317
-
- Durable Medical Equipment & Medical Supplies
- Gresham, OR
- NPI 1609635507
-
- Durable Medical Equipment & Medical Supplies
- Beaverton, OR
- NPI 1619736519
-
- Durable Medical Equipment & Medical Supplies
- Clackamas, OR
- NPI 1972362879
-
- Physical Therapy Clinic/Center
- Gresham, OR
- NPI 1487789657
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442880000000",
"number": "1265801070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24076 SE STARK ST",
"address_2": "SUITE 200",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970303373",
"telephone_number": "503-491-1666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24076 SE STARK ST",
"address_2": "SUITE 200",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970303373",
"telephone_number": "503-491-1666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLINTON",
"first_name": "PATRICK",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-22",
"last_updated": "2015-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "61355",
"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 Sep 22, 2015; 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.