Individual provider Active NPI

Nicholas R Steller, PT

  • Orthopedic Physical Therapist
  • Keizer, OR
National Provider Identifier
1306376363
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
62291 Issued in OR
Practice address
109 McNary Estates Dr N
Keizer, OR 97303-7459
Phone
(503) 463-5231
Fax
(503) 463-5175
NPI assigned
Jun 13, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 62291 OR Primary

Addresses

Primary practice location

109 McNary Estates Dr N
Keizer, OR 97303-7459

Mailing address

685 36TH Ave NE
Salem, OR 97301-4741
Phone (503) 540-8701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
PT Northwest LLC Past Accepting new patients
Sansum Clinic Past Accepting new patients

Organizations & group practices 2

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": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1306376363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 36TH AVE NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014741",
            "telephone_number": "503-540-8701",
            "fax_number": "503-371-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 MCNARY ESTATES DR N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973037459",
            "telephone_number": "503-463-5231",
            "fax_number": "503-463-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STELLER",
        "first_name": "NICHOLAS",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-13",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OR",
            "license": "62291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keizer, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.