Individual provider Active NPI

Peter Thomas Dills

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1679867907
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6524 Issued in OR
Practice address
1307 NE 102ND Ave
Suite G
Portland, OR 97220-3980
Phone
(503) 253-0924
Fax
(503) 256-5469
NPI assigned
Jun 3, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

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 6524 OR Primary

Addresses

Primary practice location

1307 NE 102ND Ave
Suite G
Portland, OR 97220-3980

Mailing address

16083 SW Upper Boones Ferry Rd
Suite 300
Tigard, OR 97224-7736
Phone (503) 443-6156

Other identifiers 3

IdentifierTypeStateIssuer
500635534MedicaidOR
P01417734OtherORRR MEDICARE PTAN
P01106221OtherRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110720000691 OR Practitioner - Physical Therapist in Private Practice 3173791092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapeutic Associates IncGroup PAC ID 0042116279, 319 clinicians

Practice addresses (Care Compare)

4829 NE Martin Luther King Blvd
Suite 101
Portland, OR 97211-3491
Phone (503) 283-8133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6524ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Associates Inc Physical Therapist Current Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Jun 3, 2011 Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Jun 3, 2011 Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

16315 SW Barrows Rd
Ste 205
Beaverton, OR 97007
Phone (503) 521-0500

2911 Tennyson Ave
Ste 204
Eugene, OR 97408
Phone (541) 515-6194

702 SW Ramsey Ave
Ste 220
Grants Pass, OR 97527
Phone (541) 479-0765

5955 Shoreview Ln N
Ste 100
Keizer, OR 97303
Phone (503) 463-4221

10215 SW Parkway
Ste D
Portland, OR 97225
Phone (503) 292-3583

4829 NE Mlk Jr Blvd
Ste 101
Portland, OR 97211
Phone (503) 283-8133

1307 NE 102nd Ave
Ste G
Portland, OR 97220
Phone (503) 253-0924

8028 NE Glisan St
Ste B
Portland, OR 97213
Phone (503) 253-0924

2040 NW Newcastle St
Roseburg, OR 97471
Phone (541) 673-1808

58147 Columbia River Hwy
Ste A
Saint Helens, OR 97051
Phone (503) 397-1914

20055 SW Pacific Hwy
Ste 110
Sherwood, OR 97140
Phone (503) 625-1691

16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224
Phone (503) 443-6153

29100 SW Town Center Loop W
Ste 190
Wilsonville, OR 97070
Phone (503) 570-7600

Interoperability endpoints

  • Direct secure messaging: peter.dills.1@31414.direct.athenahealth.com

Organizations & group practices 5

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": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1679867907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD",
            "address_2": "SUITE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "503-443-6156",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 NE 102ND AVE",
            "address_2": "SUITE G",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972203980",
            "telephone_number": "503-253-0924",
            "fax_number": "503-256-5469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLS",
        "first_name": "PETER",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-03",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "6524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500635534",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01417734",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01106221",
            "state": null
        }
    ],
    "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 Mar 23, 2015; 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.