Individual provider Active NPI

Alix Sklarew

  • Orthopedic Physical Therapist
  • Portland, OR
National Provider Identifier
1447765433
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
63105 Issued in OR
Practice address
825 NE 20TH Ave Ste 140
Portland, OR 97232-2275
Phone
(774) 208-3779
NPI assigned
Dec 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 294049 CA
Orthopedic Physical Therapist 2251X0800X 63105 OR Primary

Addresses

Primary practice location

825 NE 20TH Ave Ste 140
Portland, OR 97232-2275

Mailing address

2051 N Rosa Parks Way
Portland, OR 97217-4939
Phone (774) 208-3779

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
63105ORMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centered Health Physical Therapy and Pilates LLC CurrentSince Jan 28, 2024 Accepting new patients

Locations

825 NE 20th Ave
Ste 140
Portland, OR 97232
Phone (503) 461-9664

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1447765433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 N ROSA PARKS WAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972174939",
            "telephone_number": "774-208-3779",
            "fax_number": "774-208-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 NE 20TH AVE STE 140",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322275",
            "telephone_number": "774-208-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKLAREW",
        "first_name": "ALIX",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "294049",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OR",
            "license": "63105",
            "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 Jan 18, 2024; 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.