Aegis Group Practice LLC
Organization Active NPI Physical Therapist · Lake Oswego, OR
NPI 1598529778 · NPPES record last updated Feb 8, 2024
Key facts
- NPI
- 1598529778
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 1200 Overlook Dr
Lake Oswego, OR 97034-6605 - Phone
- (479) 201-6091
- NPI assigned
- Feb 8, 2024
- Organization subpart
- No
Authorized official
- Name
- Tracy McCall
- Title
- Credentialing
- Phone
- (479) 201-6091
Other NPIs on the same Medicare enrollment 6
Corporate family (same tax ID) 4
Practitioners 7
-
Courtney Lindsey, MOT
-
Lisa S Wolf, OTR/L
-
Nicole Schweitz, BA, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230607003040 | OR | Part B Supplier - Clinic/Group Practice | 5193036432 |
Receives reassigned benefits from 12 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Beaverton, OR; Bend, OR; Lake Oswego, OR; Sherwood, OR |
National Provider Directory
- Tax ID family
- Aegis Group Practice
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
1200 Overlook Dr
Lake Oswego, OR 97034-6605
Mailing address
4933 Old Greenwood Rd
Fort Smith, AR 72903-6906
Other providers in Lake Oswego, OR
- Emily Adair
- Hannah Adams
- Jarret Robert Addleman
- Advanced Acupuncture Inc2
- Advanced Aesthetics & Integrated Medical Center
- Alexis Ahlin
- Brook Ahnemann
- Alexis Storms Aiger
- Diane Margaret Akasaka
- Joanna Albergo
All providers in Lake Oswego, OR · Physical Therapist in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.