Individual provider Active NPI

Jennifer Catherine Monaco, PT, DPT

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1396260386
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
62286 Issued in OR
Practice address
7515 NE Ambassador PL Ste C
Portland, OR 97220-1379
Phone
(503) 261-8599
Fax
(503) 408-8932
NPI assigned
Aug 10, 2017
Last updated
Dec 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT60771908 WA
Physical Therapist 225100000X PTP-PT-LIC-17080 MT
Physical Therapist 225100000X 62286 OR Primary

Addresses

Primary practice location

7515 NE Ambassador PL Ste C
Portland, OR 97220-1379

Mailing address

7515 NE Ambassador PL Ste C
Portland, OR 97220-1379
Phone (503) 261-8599

Other practice location 1

68 Willow Rd
Menlo Park, CA 94025-3653
Phone (866) 839-6979

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

LicenseStateTypeSpecialty
PTP-PT-LIC-17080MTMDPhysical Therapist
62286ORMDPhysical Therapist
PT60771908WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Medical Center PS PastSince Aug 26, 2022 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1396260386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7515 NE AMBASSADOR PL STE C",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972201379",
            "telephone_number": "503-261-8599",
            "fax_number": "503-408-8932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7515 NE AMBASSADOR PL STE C",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972201379",
            "telephone_number": "503-261-8599",
            "fax_number": "503-408-8932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONACO",
        "first_name": "JENNIFER",
        "middle_name": "CATHERINE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-10",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60771908",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "PTP-PT-LIC-17080",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62286",
            "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 Dec 8, 2022; 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.