Individual provider Active NPI

Melisa Louise Abesa

  • Physical Therapist
  • Salem, OR
National Provider Identifier
1295148203
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60623 Issued in OR
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

Updated by the provider on Apr 18, 2018

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 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

IdentifierTypeStateIssuer
0327643OtherORWA L&I
P01528690OtherORRR MEDICARE
500672729MedicaidOR
P01676405OtherORRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 LLCGroup PAC ID 6709155534, 10 clinicians

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

OrganizationSpecialtyStatusNew patients
Stratos Group LLC Physical Therapist CurrentSince Apr 2, 2019 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.

Verify at the official NPI Registry.