Individual provider Active NPI

Samuel S Schroetke, DPT

  • Physical Therapist
  • Hillsboro, OR
National Provider Identifier
1265831762
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60685 Issued in OR
Practice address
862 SE Oak St.
Suite 2a
Hillsboro, OR 97123
Phone
(503) 844-6565
Fax
(503) 844-4225
NPI assigned
Aug 20, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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 60685 OR Primary

Addresses

Primary practice location

862 SE Oak St.
Suite 2a
Hillsboro, OR 97123

Mailing address

862 SE Oak St.
Suite 2a
Hillsboro, OR 97123
Phone (503) 844-6565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Lake Physical Therapy and Rehab LP Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients
Impact Physical Therapy, LLC Physical Therapist PastSince Feb 3, 2015 Accepting new patients

Locations

620 SE Oak St
Ste A
Hillsboro, OR 97123
Phone (503) 648-0661

101 S State St
Ste 4200
Lake Oswego, OR 97034
Phone (503) 636-3025

4606 SE Boardman Ave
Portland, OR 97267
Phone (503) 353-9776

21 Cowlitz St
Saint Helens, OR 97051
Phone (503) 396-5411

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.

NPI Registry JSON

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1265831762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "862 SE OAK ST.",
            "address_2": "SUITE 2A",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "97123",
            "telephone_number": "503-844-6565",
            "fax_number": "503-844-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "862 SE OAK ST.",
            "address_2": "SUITE 2A",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "97123",
            "telephone_number": "503-844-6565",
            "fax_number": "503-844-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROETKE",
        "first_name": "SAMUEL",
        "middle_name": "S",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-20",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.