Individual provider Active NPI

Lilly Lee, PT

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1275428575
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3205 Issued in OR
Practice address
4475 SW Scholls Ferry Rd Ste 258
Portland, OR 97225-1958
Phone
(503) 292-5882
NPI assigned
Jun 9, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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 3205 OR Primary

Addresses

Primary practice location

4475 SW Scholls Ferry Rd Ste 258
Portland, OR 97225-1958

Mailing address

145 Skyline Ave
Astoria, OR 97103-6437
Phone (503) 791-6874

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260424002275 OR Practitioner - Physical Therapist in Private Practice 0244707453 Reassigns benefits to 1 organization
Practice locations: Portland, OR

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Mayo Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
H and P Goodell IncGroup PAC ID 1153340476, 8 clinicians

Practice addresses (Care Compare)

4475 SW Scholls Ferry Rd
Suite 258
Portland, OR 97225-1958
Phone (503) 292-5882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3205ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
H & P Goodell, Inc. CurrentSince Jun 15, 2025 Accepting new patients

Locations

4475 SW Scholls Ferry Rd
Ste 258
Portland, OR 97225
Phone (503) 292-5882

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": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1275428575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 SKYLINE AVE",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971036437",
            "telephone_number": "503-791-6874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 SW SCHOLLS FERRY RD STE 258",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251958",
            "telephone_number": "503-292-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "LILLY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "3205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.