Jennifer Bissig, DPT
Individual provider Active NPI Physical Therapist · Canby, OR
NPI 1285779249 · NPPES record last updated Nov 24, 2009
Key facts
- NPI
- 1285779249
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5844 (OR)
- Practice address
- 365 S Redwood St
Canby, OR 97013-2405 - Phone
- (503) 651-2020
- NPI assigned
- Feb 20, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North Lake Physical Therapy and Rehab LP
Practice addresses (Care Compare)
4606 SE Boardman Ave
Milwaukie, OR 97267-5930
Phone (503) 353-9776
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090715000453 | OR | Practitioner - Physical Therapist in Private Practice | 4880746247 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5844 | OR | MD | Chiropractor |
| 34421 | CA | MD | Physical Therapist |
| 070.014953 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Lake Physical Therapy and Rehab LP | Physical Therapist | Current |
Accepting new patients |
Locations
365 S Redwood St
Canby, OR 97013
Phone (503) 266-4263
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.014953 | IL | |
| Physical Therapist | 225100000X | 34421 | CA | |
| Physical Therapist | 225100000X | 5844 | OR | Yes |
Addresses
Primary practice location
365 S Redwood St
Canby, OR 97013-2405
Mailing address
365 S Redwood St
Canby, OR 97013-2405
Other providers in Canby, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.