Active NPI
Melisa Louise Abesa
- Physical Therapist
- Salem, OR
National Provider Identifier
1295148203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 60623
- Practice address
- 3270 Liberty Rd S
Salem, OR 97302 - Phone
- (503) 371-0779
- Fax
- (503) 371-0886
- NPI assigned
- Jun 6, 2014
- Sex
- Female
- 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 | 60623 | OR | Primary |
Addresses
Primary practice location
3270 Liberty Rd S
Salem, OR 97302
Mailing address
3270 Liberty Rd S
Salem, OR 97302
Phone (503) 371-0779
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0327643 | Other | OR | WA L&I |
| P01528690 | Other | OR | RR MEDICARE |
| 500672729 | Medicaid | OR | |
| P01676405 | Other | OR | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140905002516 | OR | Practitioner - Physical Therapist in Private Practice | 2264650126 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Stratos Group LLC
Practice addresses (Care Compare)
20510 SW Roy Rogers Rd
Suite 120
Sherwood, OR 97140-9320
Phone (971) 213-3335
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stratos Group LLC | Physical Therapist | Current | Accepting new patients |
Locations
20510 SW Roy Rogers Rd
Ste 120
Sherwood, OR 97140
Phone (971) 213-3335
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": "1402012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524009600000",
"number": "1295148203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3270 LIBERTY RD S",
"city": "SALEM",
"state": "OR",
"postal_code": "97302",
"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": "3270 LIBERTY RD S",
"city": "SALEM",
"state": "OR",
"postal_code": "97302",
"telephone_number": "503-371-0779",
"fax_number": "503-371-0886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABESA",
"first_name": "MELISA",
"middle_name": "LOUISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-06",
"last_updated": "2018-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "60623",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA L&I",
"identifier": "0327643",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01528690",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500672729",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01676405",
"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 Apr 18, 2018; 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.