Individual provider Active NPI

Andrea Patricia Bulat, P.T.

  • Physical Therapist
  • Salem, OR
National Provider Identifier
1285866590
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6049 Issued in OR
Practice address
1025 2ND St NW
Salem, OR 97304-4001
Phone
(503) 371-0779
Fax
(503) 371-0886
NPI assigned
Aug 20, 2009
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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 6049 OR Primary

Addresses

Primary practice location

1025 2ND St NW
Salem, OR 97304-4001

Mailing address

1025 2ND St NW
Salem, OR 97304-4001
Phone (503) 371-0779

Other practice location 1

1411 S Potomac St Ste 400
Aurora, CO 80012-4540
Phone (303) 695-6060

Other practice location 2

1248 S Broadway
Denver, CO 80210-1504
Phone (720) 699-9095

Other identifiers 1

IdentifierTypeStateIssuer
6049OtherORLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090909000150 OR Practitioner - Physical Therapist in Private Practice 3870648264 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
43.24 of 100Reported as group
Quality
73.53
Promoting interoperability
0
Improvement activities
0
Cost
70.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6049ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Erhardt Physical Therapy and Sports Medicine, LLC Physical Therapist CurrentSince Feb 1, 2016 Accepting new patients
Northwest Rehabilitation Associates, Inc. Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients
Impact Physical Therapy, LLC Physical Therapist Past Accepting new patients
Kab Physical Therapy LLC Physical Therapist PastSince Jan 1, 2011 Accepting new patients
Andrew Physical Therapy, Inc PastSince Sep 1, 2008 Accepting new patients
Corvallis Sport and Spine Physical Therapy Inc Physical Therapist Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

735 SW 158th Ave
Ste 160
Beaverton, OR 97006
Phone (503) 597-0035

210 W Ellendale Ave
Ste 100
Dallas, OR 97338
Phone (503) 623-2433

3270 Liberty Rd S
Salem, OR 97302
Phone (503) 371-0779

51385 SW Old Portland Rd
Scappoose, OR 97056
Phone (503) 543-7768

7800 SW Durham Rd
Ste 500
Tigard, OR 97224
Phone (503) 937-0090

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1285866590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 2ND ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044001",
            "telephone_number": "503-371-0779",
            "fax_number": "503-371-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 2ND ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044001",
            "telephone_number": "503-371-0779",
            "fax_number": "503-371-0886"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 S Potomac St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800124540",
            "country_code": "US",
            "telephone_number": "303-695-6060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1248 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802101504",
            "country_code": "US",
            "telephone_number": "720-699-9095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULAT",
        "first_name": "ANDREA",
        "middle_name": "PATRICIA",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-20",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "6049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6049",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.