Individual provider Active NPI

Asumi Ann Ohgushi, PT, DPT

  • Physical Therapy Clinic/Center
  • Portland, OR
National Provider Identifier
1639780646
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
63820 Issued in OR
Practice address
4424 NE Glisan St
Portland, OR 97213-2331
Phone
(503) 477-5167
NPI assigned
Aug 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 63820 OR Primary

Addresses

Primary practice location

4424 NE Glisan St
Portland, OR 97213-2331

Mailing address

1729 NE 17TH Ave Apt 26
Portland, OR 97212-4504
Phone (971) 645-0262

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210603000454 OR Practitioner - Physical Therapist in Private Practice 0840699385 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
KJB Consulting Corporation Physical Therapy CurrentSince May 19, 2021 Accepting new patients

Locations

1427 NW Flanders St
Ste A
Portland, OR 97209
Phone (503) 473-6725

2525 NW Lovejoy St
Ste 202
Portland, OR 97210
Phone (503) 223-3078

3934 NE Martin Luther King Jr Blvd
Ste 203
Portland, OR 97212
Phone 5032231856301

Organizations & group practices 1

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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1639780646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 NE 17TH AVE APT 26",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972124504",
            "telephone_number": "971-645-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4424 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132331",
            "telephone_number": "503-477-5167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHGUSHI",
        "first_name": "ASUMI",
        "middle_name": "ANN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OR",
            "license": "63820",
            "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 Aug 13, 2020; 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.

Verify at the official NPI Registry.