Individual provider Active NPI

Ross Bisera, PTA

  • Physical Therapy Assistant
  • Medford, OR
National Provider Identifier
1477926616
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
09184 Issued in OR
Practice address
1904 Sky Park Dr
Medford, OR 97504-4735
Phone
(541) 773-2999
NPI assigned
Nov 10, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 09184 OR Primary

Addresses

Primary practice location

1904 Sky Park Dr
Medford, OR 97504-4735

Mailing address

3163 Juniper RDG Apt 4
Medford, OR 97504-5780
Phone (808) 269-3028

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
09184ORMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anders Incorporated PastSince Jan 11, 2016 Accepting new patients

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": "1447113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1477926616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3163 JUNIPER RDG APT 4",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045780",
            "telephone_number": "808-269-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 SKY PARK DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044735",
            "telephone_number": "541-773-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISERA",
        "first_name": "ROSS",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-10",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "09184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.