Individual provider Active NPI

Robert Reynoso

  • Physical Therapist
  • Beaverton, OR
National Provider Identifier
1649845728
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
11709 SW Beaverton Hillsdale Hwy Ste B-6
Beaverton, OR 97005-2992
Phone
(971) 327-4906
NPI assigned
May 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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 Primary

Addresses

Primary practice location

11709 SW Beaverton Hillsdale Hwy Ste B-6
Beaverton, OR 97005-2992

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210621002488 OR Practitioner - Physical Therapist in Private Practice 6800296369 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
Erhardt Physical Therapy and Sports Medicine LLCGroup PAC ID 1153214739, 58 clinicians

Practice addresses (Care Compare)

11709 SW Beaverton Hillsdale Hwy
Suite B 6
Beaverton, OR 97005-2992
Phone (971) 327-4906

Merit-based Incentive Payment System (MIPS)

Final score
85.22 of 100Reported as group
Quality
87.65
Improvement activities
40
Cost
73.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Erhardt Physical Therapy and Sports Medicine, LLC Physical Therapist CurrentSince May 17, 2021 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

735 SW 158th Ave
Ste 160
Beaverton, OR 97006
Phone (503) 597-0035

14603 SW Teal Blvd
Beaverton, OR 97007
Phone (941) 348-4641

11709 SW Beaverton Hillsdale Hwy
Ste B6
Beaverton, OR 97005
Phone (971) 327-4906

11977 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 486-6944

2259 SE Tualatin Valley Hwy
Hillsboro, OR 97123
Phone (971) 708-7322

5262 NE Brookwood Pkwy
Hillsboro, OR 97124
Phone (503) 395-3000

3322 N Vancouver Ave
Portland, OR 97227

7545 SW Barnes Rd
Ste 117
Portland, OR 97225
Phone (503) 205-6704

51385 SW Old Portland Rd
Scappoose, OR 97056
Phone (503) 543-7768

20655 SW Roy Rogers Rd
Sherwood, OR 97140
Phone (503) 862-5540

30060 SW Boones Ferry Rd
Ste C34
Wilsonville, OR 97070
Phone (503) 404-3068

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": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1649845728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11709 SW BEAVERTON HILLSDALE HWY STE B-6",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052992",
            "telephone_number": "971-327-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOSO",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.