Individual provider Active NPI

Sinead Margaret Clancy, DPT, PH.D

  • Physical Therapist
  • Beaverton, OR
National Provider Identifier
1689933681
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
61980 Issued in OR
Practice address
3905 SW 117TH Ave
Beaverton, OR 97005-8905
Phone
(619) 962-2159
NPI assigned
May 10, 2012
Last updated
Apr 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2018

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 61980 OR Primary

Addresses

Primary practice location

3905 SW 117TH Ave
Beaverton, OR 97005-8905

Mailing address

3859 NW Sunset View Terr
Portland, OR 97229
Phone (619) 962-2159

Other practice location 1

735 SW 158th Ave
Suite 160
Beaverton, OR 97006-4952
Phone (503) 597-0035

Other identifiers 1

IdentifierTypeStateIssuer
1669977898OtherCMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170221002143 OR Practitioner - Physical Therapist in Private Practice 0244514180 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultra Physical Therapy and Hand Center LLCGroup PAC ID 1951666346, 2 clinicians

Practice addresses (Care Compare)

16849 SW 65TH Ave
Lake Oswego, OR 97035-7865
Phone (503) 662-6403

3905 SW 117TH Ave
Suite a
Beaverton, OR 97005-8905
Phone (503) 662-6403

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Erhardt Physical Therapy and Sports Medicine, LLC Physical Therapist CurrentSince Jan 30, 2017 Accepting new patients
Hopstown Physical Therapy Physical Therapist CurrentSince May 1, 2023 Accepting new patients
Ultra Physical Therapy & Hand Center, LLC Physical Therapist CurrentSince May 1, 2018 Accepting new patients
Ultra Physical Therapy & Hand Center II LLC Physical Therapist CurrentSince Feb 11, 2022 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

3905 SW 117th Ave
Beaverton, OR 97005
Phone (619) 962-2159

3905 SW 117th Ave
Ste A
Beaverton, OR 97005
Phone (503) 662-6403

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

16849 SW 65th Ave
Lake Oswego, OR 97035
Phone (503) 598-8603

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1689933681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3859 NW SUNSET VIEW TERR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97229",
            "telephone_number": "619-962-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 SW 117TH AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970058905",
            "telephone_number": "619-962-2159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "735 SW 158th Ave",
            "address_2": "Suite 160",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970064952",
            "country_code": "US",
            "telephone_number": "503-597-0035",
            "fax_number": "503-726-5490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLANCY",
        "first_name": "SINEAD",
        "middle_name": "MARGARET",
        "name_prefix": "Dr.",
        "credential": "DPT, PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-10",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "61980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS",
            "identifier": "1669977898",
            "state": null
        }
    ],
    "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 Apr 27, 2018; 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.