Individual provider Active NPI

Mary McCauley Stewart, DPT

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1720232069
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5796 Issued in OR
Practice address
6040 SE Belmont St
Portland, OR 97215
Phone
(971) 206-5200
Fax
(971) 206-5209
NPI assigned
Nov 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X OR
Physical Therapist 225100000X 5796 OR Primary

Addresses

Primary practice location

6040 SE Belmont St
Portland, OR 97215

Mailing address

4560 SE International Way, Ste. 100
Consonus Healthcare Services
Milwaukie, OR 97222
Phone (971) 206-5200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240423002072 OR Practitioner - Physical Therapist in Private Practice 6103265103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehab Specialists Outpatient LLCGroup PAC ID 6507254497, 46 clinicians

Practice addresses (Care Compare)

1300 NE 16TH Ave
Portland, OR 97232-1467
Phone (503) 288-6671

1417 SE 107TH Ave
Portland, OR 97216-3156
Phone (503) 408-0404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5796ORMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Specialists Outpatient, LLC Physical Therapist Current Accepting new patients
Rehab Specialists Outpatient, LLC Physical Therapist CurrentSince Feb 15, 2024 Accepting new patients
Rehab Specialists Outpatient, LLC Physical Therapist CurrentSince Feb 15, 2024 Accepting new patients

Locations

4560 SE International Way
Ste 100
Portland, OR 97222
Phone (971) 206-5129

Organizations & group practices 3

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": "1226534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1720232069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY, STE. 100",
            "address_2": "CONSONUS HEALTHCARE SERVICES",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "97222",
            "telephone_number": "971-206-5200",
            "fax_number": "971-206-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 SE BELMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97215",
            "telephone_number": "971-206-5200",
            "fax_number": "971-206-5209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MARY",
        "middle_name": "MCCAULEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-13",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "5796",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 30, 2024; 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.