Individual provider Active NPI

Kindra Fish, PT

  • Physical Therapist
  • Lake Oswego, OR
National Provider Identifier
1497278626
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
62338 Issued in OR
Practice address
4811 Meadows Rd Ste 101
Lake Oswego, OR 97035-2542
Phone
(360) 254-6161
NPI assigned
Jul 19, 2017
Last updated
Jan 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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 62338 OR Primary

Addresses

Primary practice location

4811 Meadows Rd Ste 101
Lake Oswego, OR 97035-2542

Mailing address

200 NE Mother Joseph PL Ste 210
Vancouver, WA 98664-3295
Phone (360) 254-6161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170830001751 OR Practitioner - Physical Therapist in Private Practice 2466725205 Reassigns benefits to 2 organizations
I20250305001282 WA Practitioner - Physical Therapist in Private Practice 2466725205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Surgical Specialists PCGroup PAC ID 4183527153, 118 clinicians

Practice addresses (Care Compare)

200 NE Mother Joseph PL
110 Rebound Orthopedics
Vancouver, WA 98664-3293
Phone (360) 254-6161

4811 Meadows Rd
Suite 101
Lake Oswego, OR 97035-2542
Phone (503) 635-2323

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Surgical Specialists, P.C. CurrentSince Jan 9, 2023 Accepting new patients
Active Edge Physical Therapy & Sports Medicine P.C. CurrentSince May 26, 2019 Accepting new patients
Northwest Surgical Specialists PC CurrentSince Jan 9, 2023 Accepting new patients
J and D Physical Therapy Services Physical Therapist Past Accepting new patients
Gateway Sports Medicine & Rehabilitation PC Physical Therapist PastSince Sep 23, 2018 Accepting new patients

Locations

4811 Meadows Rd
Ste 101
Lake Oswego, OR 97035
Phone (503) 635-2323

1 N Center Court St
Ste 11
Portland, OR 97227
Phone (503) 732-6863

2020 8th Ave
Ste D
West Linn, OR 97068
Phone (503) 387-5449

200 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2990

200 NE Mother Joseph Pl
Ste 110
Vancouver, WA 98664
Phone (360) 256-8584

200 NE Mother Joseph Pl
Ste 210
Vancouver, WA 98664
Phone (360) 449-1145

2121 NE 139th St
Ste 325
Vancouver, WA 98686
Phone (360) 449-8700

Interoperability endpoints

  • Direct secure messaging: kindra.fishdpt.p1@direct.reboundmd.nextgenshare.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1497278626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL STE 210",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643295",
            "telephone_number": "360-254-6161",
            "fax_number": "360-449-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 MEADOWS RD STE 101",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352542",
            "telephone_number": "360-254-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "KINDRA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.