Active NPI
Steven Masuichi Nakano, P.T.
- Orthopedic Physical Therapist
- Clackamas, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 2719
- Practice address
- 10180 SE Sunnyside Rd
Clackamas, OR 97015-8970 - Phone
- (503) 813-2000
- NPI assigned
- Nov 8, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 2719 | OR | Primary |
Addresses
Primary practice location
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Mailing address
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (503) 813-2000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 227892 | Medicaid | OR | |
| 5467820001 | Other | OR | MEDICARE DME NUMBER |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | snakano2339@direct.theportlandclinic.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, OR
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2719 | OR | MD | Internist Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Proactive Orthopedic and Sports Physical Therapy of Battle Ground | Past | Accepting new patients | |
| Proactive Orthopedic and Sports Physical Therapy of East Vancouver LLC | Past | Accepting new patients | |
| New Proactive LLC | Orthopedic | Past | Accepting new patients |
Locations
10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
500 NE Multnomah St
Fl 11
Portland, OR 97232
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
14406 NE 20th Ave
Vancouver, WA 98686
Phone (360) 418-6001
Organizations & group practices 6
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.
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
WA
-
- General Practice Physician
- Portland, OR
- NPI 1063990695
-
- Clinic/Center
- Hillsboro, OR
- NPI 1942718622
-
- Physical Therapy Clinic/Center
- Battle Ground, WA
- NPI 1922235738
-
- Physical Therapy Clinic/Center
- Vancouver, WA
- NPI 1053326561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719360000000",
"number": "1639150428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10180 SE SUNNYSIDE RD",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970158970",
"telephone_number": "503-813-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10180 SE SUNNYSIDE RD",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970158970",
"telephone_number": "503-813-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAKANO",
"first_name": "STEVEN",
"middle_name": "MASUICHI",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-08",
"last_updated": "2024-06-26",
"certification_date": "2024-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "OR",
"license": "2719",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "227892",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE DME NUMBER",
"identifier": "5467820001",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "snakano2339@direct.theportlandclinic.net",
"affiliation": "N",
"address_1": "9250 SW Hall Blvd",
"city": "Tigard",
"state": "OR",
"country_code": "US",
"postal_code": "97223",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Clackamas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.