Eric Herbert Vicinus, PT, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

64971 Issued in OR

Practice address

18215 NW West Union Rd Ste B
Portland, OR 97229-2139

Phone

(971) 979-0979

NPI assigned

Jun 13, 2023

Last updated

Jun 13, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Stratos Group LLC

  dba Evolve Physical Therapy

  • Physical Therapy Clinic/Center
  • Sherwood, OR
  • NPI 1003357930

  Orthopedic

  NPD

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1447934153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1186 SE HIGHFIELD AVE",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18215 NW WEST UNION RD STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972292139",
            "telephone_number": "971-979-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICINUS",
        "first_name": "ERIC",
        "middle_name": "HERBERT",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OR",
            "license": "64971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vibrant ABA Oregon LLC
• Vibrant Mental Wellness LLC
• Aaron Thomas Vice
• Timothy Vice, LCSW
• Abdi Yamil Vicenciodelmoral
• Janelle Marie Vick
• Linda Catherine Vick, MA, LPC, CADC
• Charlee Fay Vickers
• Edythe Marsh Vickers, ND,LAC
• Lynaudry Vickers, PMHNP

• Orthopedic Physical Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Orthopedic Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.