Individual provider Active NPI

Justin Hoggarth, PT, DPT

  • Physical Therapist
  • Redmond, OR
National Provider Identifier
1700207610
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60423 Issued in OR
Practice address
1315 NW 4TH St Apt B
Redmond, OR 97756-1328
Phone
(541) 504-2350
Fax
(541) 504-2354
NPI assigned
Dec 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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 60423 OR Primary

Addresses

Primary practice location

1315 NW 4TH St Apt B
Redmond, OR 97756-1328

Mailing address

805 SW Industrial Way Ste 3
Bend, OR 97702-1093
Phone (541) 504-2350

Other practice location 1

1950 E Desert Inn Rd
Las Vegas, NV 89169-3250
Phone (702) 735-1501

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150910001060 OR Practitioner - Physical Therapist in Private Practice 7113141052 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1315 NW 4TH St
Apt B
Redmond, OR 97756-1328
Phone (541) 504-2350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60423ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rebound Physical Therapy Limited Partnership Physical Therapist CurrentSince Sep 1, 2020 Accepting new patients
Rebound Physical Therapy Limited Partnership Physical Therapist CurrentSince Sep 1, 2020 Accepting new patients
North Lake Physical Therapy and Rehab LP Physical Therapist CurrentSince Aug 24, 2015 Accepting new patients

Locations

805 SW Industrial Way
Ste 3
Bend, OR 97702
Phone (541) 323-5864

365 S Redwood St
Canby, OR 97013
Phone (503) 266-4263

101 S State St
Ste 4200
Lake Oswego, OR 97034
Phone (503) 636-3025

4606 SE Boardman Ave
Portland, OR 97267
Phone (503) 353-9776

1590 NE 3rd St
Ste 2
Prineville, OR 97754
Phone (541) 416-7476

1315 NW 4th St
Apt B
Redmond, OR 97756
Phone (541) 504-2350

1717 NE 2nd St
Redmond, OR 97756
Phone (541) 332-9045

21 Cowlitz St
Saint Helens, OR 97051
Phone (503) 396-5411

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1700207610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SW INDUSTRIAL WAY STE 3",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021093",
            "telephone_number": "541-504-2350",
            "fax_number": "541-504-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 NW 4TH ST APT B",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561328",
            "telephone_number": "541-504-2350",
            "fax_number": "541-504-2354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 E Desert Inn Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891693250",
            "country_code": "US",
            "telephone_number": "702-735-1501",
            "fax_number": "702-735-1875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOGGARTH",
        "first_name": "JUSTIN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-18",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.