Individual provider Active NPI

Lisa M. Gilbertson, MSPT

  • Physical Therapist
  • Hillsboro, OR
National Provider Identifier
1346324191
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3825 Issued in OR
Practice address
1950 NE 102ND Ave
Hillsboro, OR 97006-6514
Phone
(503) 726-0202
Fax
(866) 403-7867
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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 3825 OR Primary

Addresses

Primary practice location

1950 NE 102ND Ave
Hillsboro, OR 97006-6514

Mailing address

25195 SW Parkway Ave Ste 205
Wilsonville, OR 97070-9689
Phone (503) 570-3665

Other identifiers 6

IdentifierTypeStateIssuer
M1036 36OtherORPACIFIC SOURCE HEALTH PLA
2003875-02OtherORREGENCE BC/HMO
0210756OtherWAWA DEPT OF LABOR & INDUS
278297MedicaidOR
340869OtherORPROVIDENCE HEALTH PLAN
885103002OtherORREGENCE BC/BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040407001657 OR Practitioner - Physical Therapist in Private Practice 8325031925 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TSL Well LLCGroup PAC ID 0345776050, 11 clinicians

Practice addresses (Care Compare)

15677 SW Oregon St
Sherwood, OR 97140-9386
Phone (503) 625-9481

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3825ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
TSL Well LLC Physical Therapist CurrentSince Dec 1, 2024 Accepting new patients
Premere Rehab LLC Physical Therapist CurrentSince Jun 17, 2019 Accepting new patients
Premere Rehab LLC Physical Therapist CurrentSince Jun 17, 2019 Accepting new patients
PT Northwest LLC Past Accepting new patients
Physical Therapy Northwest Limited Partnership Physical Therapist Past Accepting new patients

Locations

3330 SE Three Mile Ln
McMinnville, OR 97128
Phone (971) 645-1650

822 Golf View Dr
Medford, OR 97504
Phone (541) 774-1822

8100 SW Nyberg St
Ste 200
Tualatin, OR 97062
Phone (503) 570-3365

Organizations & group practices 5

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1346324191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25195 SW PARKWAY AVE STE 205",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709689",
            "telephone_number": "503-570-3665",
            "fax_number": "503-570-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 NE 102ND AVE",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "970066514",
            "telephone_number": "503-726-0202",
            "fax_number": "866-403-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERTSON",
        "first_name": "LISA",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "3825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFIC SOURCE HEALTH PLA",
            "identifier": "M1036 36",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BC/HMO",
            "identifier": "2003875-02",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA DEPT OF LABOR & INDUS",
            "identifier": "0210756",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278297",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDENCE HEALTH PLAN",
            "identifier": "340869",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BC/BS",
            "identifier": "885103002",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.