Active NPI
Rehab Specialists Outpatient, LLC
- Clinic/Center
- Milwaukie, OR
National Provider Identifier
1407523657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- REHAB SPECIALISTS OUTPATIENT, LLC
- Practice address
- 4560 SE International Way Ste 100
Milwaukie, OR 97222-4628 - Phone
- (971) 206-5100
- Fax
- (971) 318-6508
- NPI assigned
- Aug 25, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Staci Tone
- Title
- Corporate Controller
- Phone
- (971) 206-5125
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | |||
| Occupational Therapist | 225X00000X | |||
| Speech-Language Pathologist | 235Z00000X | |||
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
4560 SE International Way Ste 100
Milwaukie, OR 97222-4628
Mailing address
4560 SE International Way Ste 100
Milwaukie, OR 97222-4628
Phone (971) 206-5100
Other names 1
- AgeSTRONG Mirabella ASU
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211206001530 | AZ | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 6507254497 |
Receives reassigned benefits from 9 practitioners Practice locations: Tempe, AZ |
Other NPIs with the same Medicare PAC ID 5
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Part of
- Rehab Specialists Outpatient LLC
Practitioners & affiliated clinicians
Practitioners 49
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Driving and Community Mobility Occupational Therapist
- Tempe, AZ
- NPI 1134371842
AZ
-
- Speech-Language Pathologist
- Tempe, AZ
- NPI 1083439772
AZ, Speech-Language Pathologist
-
- Physical Therapist
- Phoenix, AZ
- NPI 1780126227
AZ, Physical Therapist
-
- Speech-Language Pathologist
- Phoenix, AZ
- NPI 1932768892
AZ, Speech-Language Pathologist
-
- Orthopedic Physical Therapist
- Portland, OR
- NPI 1386365633
-
- Physical Therapist
- Milwaukie, OR
- NPI 1053401463
-
- Physical Therapist
- Milwaukie, OR
- NPI 1154491777
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629849600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788134400000",
"number": "1407523657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY STE 100",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "972224628",
"telephone_number": "971-206-5100",
"fax_number": "971-318-6508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY STE 100",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "972224628",
"telephone_number": "971-206-5100",
"fax_number": "971-318-6508"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REHAB SPECIALISTS OUTPATIENT, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-08-25",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A",
"authorized_official_last_name": "TONE",
"authorized_official_first_name": "STACI",
"authorized_official_title_or_position": "CORPORATE CONTROLLER",
"authorized_official_telephone_number": "971-206-5125"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "AgeSTRONG Mirabella ASU",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Milwaukie, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.