Active NPI
Joe J Paterno, P.T.
- Orthopedic Physical Therapist
- Portland, OR
National Provider Identifier
1356324560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 1187
- Practice address
- 3016 NE Broadway St
Portland, OR 97232-1811 - Phone
- (503) 287-6636
- Fax
- (503) 287-4044
- NPI assigned
- Nov 22, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 1187 | OR | Primary |
Addresses
Primary practice location
3016 NE Broadway St
Portland, OR 97232-1811
Mailing address
2444 NE 49TH Ave
Portland, OR 97213-1928
Phone (503) 284-9288
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1187 | OR | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193875200000",
"number": "1356324560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2444 NE 49TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972131928",
"telephone_number": "503-284-9288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3016 NE BROADWAY ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321811",
"telephone_number": "503-287-6636",
"fax_number": "503-287-4044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATERNO",
"first_name": "JOE",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-22",
"last_updated": "2007-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "OR",
"license": "1187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.