Individual provider Active NPI

Augustine Bernard Cantwell Doblado, DPT

  • Physical Therapist
  • Hillsboro, OR
National Provider Identifier
1619644002
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
64158 Issued in OR
Practice address
7305 SE Circuit Dr Ste 140
Hillsboro, OR 97123-1915
Phone
(971) 501-4905
NPI assigned
Aug 24, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 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 64158 OR Primary

Addresses

Primary practice location

7305 SE Circuit Dr Ste 140
Hillsboro, OR 97123-1915

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

10690 NE Cornell Rd Ste 314
Hillsboro, OR 97124-9224
Phone (503) 216-9760

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230130001070 OR Practitioner - Physical Therapist in Private Practice 7416328448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

7305 SE Circuit Dr
Suite 140
Hillsboro, OR 97129-1961
Phone (971) 501-4905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64158ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Jan 16, 2023 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 16, 2023 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon PastSince Aug 1, 2021 Accepting new patients

Locations

7305 SE Circuit Dr
Ste 140
Hillsboro, OR 97129
Phone (971) 501-4905

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

960 N 16th St
Ste 304
Springfield, OR 97477
Phone (541) 744-6172

Organizations & group practices 4

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": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1619644002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7305 SE CIRCUIT DR STE 140",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971231915",
            "telephone_number": "971-501-4905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10690 NE Cornell Rd Ste 314",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971249224",
            "country_code": "US",
            "telephone_number": "503-216-9760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOBLADO",
        "first_name": "AUGUSTINE",
        "middle_name": "BERNARD CANTWELL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-24",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.