Individual provider Active NPI

Kelvin Chang, DPT

  • Physical Therapist
  • Lake Oswego, OR
National Provider Identifier
1720949225
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
65890 Issued in OR
Practice address
16849 SW 65TH Ave
Lake Oswego, OR 97035-7865
Phone
(503) 598-8603
NPI assigned
Nov 24, 2025
Last updated
Nov 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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 65890 OR Primary

Addresses

Primary practice location

16849 SW 65TH Ave
Lake Oswego, OR 97035-7865

Mailing address

17659 SW Falling Leaf CT
Beaverton, OR 97003-7558

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260225003160 OR Practitioner - Physical Therapist in Private Practice 9133600323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1110 16TH St
Oregon City, OR 97045-1417

16849 SW 65TH Ave
Lake Oswego, OR 97035-7865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
65890ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hopstown Physical Therapy Physical Therapist CurrentSince Jan 13, 2026 Accepting new patients
Ultra Physical Therapy & Hand Center II LLC Physical Therapist CurrentSince Nov 30, 2025 Accepting new patients

Locations

3786 SW Hall Blvd
Beaverton, OR 97005
Phone (503) 626-6587

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

Organizations & group practices 2

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": "1763942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1720949225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17659 SW FALLING LEAF CT",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970037558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16849 SW 65TH AVE",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970357865",
            "telephone_number": "503-598-8603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "KELVIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-24",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "65890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; 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.