Individual provider Active NPI

Carlee Annmarie Martin, PT, DPT

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1588413397
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
65285 Issued in OR
Practice address
2808 E Burnside St
Portland, OR 97214-1830
Phone
(503) 477-4802
NPI assigned
May 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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 65285 OR Primary

Addresses

Primary practice location

2808 E Burnside St
Portland, OR 97214-1830

Mailing address

13190 SE 162ND Ave Apt 217
Happy Valley, OR 97015-3780
Phone (509) 823-7126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240731002537 OR Practitioner - Physical Therapist in Private Practice 8224575899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapydia IncGroup PAC ID 2264678226, 35 clinicians

Practice addresses (Care Compare)

2808 E Burnside St
Portland, OR 97214-1830
Phone (503) 477-4802

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Therapydia, Inc. Physical Therapist CurrentSince Jun 3, 2024 Accepting new patients
Therapydia, Inc. Physical Therapist CurrentSince Jun 3, 2024 Accepting new patients

Locations

18 E Blithedale Ave
Ste 21
Mill Valley, CA 94941

2808 E Burnside St
Portland, OR 97214
Phone (503) 477-4802

Organizations & group practices 2

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": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1588413397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13190 SE 162ND AVE APT 217",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970153780",
            "telephone_number": "509-823-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141830",
            "telephone_number": "503-477-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CARLEE",
        "middle_name": "ANNMARIE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "65285",
            "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 May 14, 2024; 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.