Individual provider Active NPI

Savannah Grosse, DPT

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1407692361
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
65322 Issued in OR
Practice address
332 NE San Rafael St
Portland, OR 97212-3948
Phone
(503) 288-2615
NPI assigned
Jul 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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 65322 OR Primary

Addresses

Primary practice location

332 NE San Rafael St
Portland, OR 97212-3948

Mailing address

332 NE San Rafael St
Portland, OR 97212-3948

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240724003616 OR Practitioner - Physical Therapist in Private Practice 2264978303 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Lake Physical Therapy and Rehab LPGroup PAC ID 4082853825, 39 clinicians
Oregon Luna Care Physical Therapy LLCGroup PAC ID 5597178087, 51 clinicians
Attain Physical TherapyGroup PAC ID 6305272659, 68 clinicians

Practice addresses (Care Compare)

101 S State St
Suite 4200
Lake Oswego, OR 97034-3977
Phone (503) 636-3028

9620 NE Tanasbourne Dr
Suite 300
Hillsboro, OR 97124-7844
Phone (866) 525-3175

9860 NW Cornell Rd
Portland, OR 97229-5250
Phone (855) 428-8246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
65322ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Lake Physical Therapy and Rehab LP Physical Therapist CurrentSince Sep 2, 2024 Accepting new patients
Oregon Luna Care Physical Therapy LLC Physical Therapist CurrentSince Feb 4, 2026 Accepting new patients

Locations

9620 NE Tanasbourne Dr
Ste 300
Hillsboro, OR 97124
Phone (833) 756-8643

101 S State St
Ste 4200
Lake Oswego, OR 97034
Phone (503) 636-3025

4606 SE Boardman Ave
Portland, OR 97267
Phone (503) 353-9776

332 NE San Rafael St
Portland, OR 97212
Phone (503) 288-2615

21 Cowlitz St
Saint Helens, OR 97051
Phone (503) 396-5411

Organizations & group practices 3

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": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1407692361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 NE SAN RAFAEL ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 NE SAN RAFAEL ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123948",
            "telephone_number": "503-288-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSE",
        "first_name": "SAVANNAH",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "65322",
            "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 Jul 1, 2024; 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.