Vivanta Neuro Geriatric Clinic

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

VIVANTA NEURO GERIATRIC CLINIC

Practice address

5441 S Macadam Ave Ste N
Portland, OR 97239-3822

Phone

(503) 960-2060

NPI assigned

Jun 18, 2026

Organization subpart

No

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

Authorized official

Name

Mini GuptaNPI 1215443999

Title

Physical Therapist

Phone

(503) 960-2060

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mini Gupta

  • Physical Therapist
  • Wilsonville, OR
  • NPI 1215443999
  NPD Authorized official

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

{
    "created_epoch": "1781740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781740800000",
    "number": "1467388595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5441 S MACADAM AVE STE N",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5441 S MACADAM AVE STE N",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393822",
            "telephone_number": "503-960-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVANTA NEURO GERIATRIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-18",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-17",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "MINI",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "503-960-2060"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Mark Vitello, AGPCNP
• Maggie Vitello, MSW
• Aaron Vitells, MD
• Paola F Vitiello, O.D.
• Vivacity Health, LLC
• Vivante Midwifery, Inc.
• Anna Vivatson, OT
• Amber Vivenzi
• Erika Viveros-Leon
• Ana Vives Barreto

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; 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.