Individual provider Active NPI

Tevis Goldfein

  • Physical Therapy Assistant
  • Brookings, OR
National Provider Identifier
1699196873
Registry record updated Dec 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
08059 Issued in OR
Practice address
500 5TH St
Brookings, OR 97415-9702
Phone
(541) 412-2000
NPI assigned
Dec 14, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 08059 OR Primary

Addresses

Primary practice location

500 5TH St
Brookings, OR 97415-9702

Mailing address

500 5TH St
Brookings, OR 97415-9702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
08059ORMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1386979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386979200000",
    "number": "1699196873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 5TH ST",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974159702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 5TH ST",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974159702",
            "telephone_number": "541-412-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDFEIN",
        "first_name": "TEVIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-14",
        "last_updated": "2013-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "08059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookings, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.