Individual provider Active NPI

Israel Sostrin, PT

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1740219500
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4725 Issued in OR
Practice address
5909 SE Division St Ste 3
Portland, OR 97206-1470
Phone
(503) 231-3633
Fax
(503) 305-4752
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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 4725 OR Primary

Addresses

Primary practice location

5909 SE Division St Ste 3
Portland, OR 97206-1470

Mailing address

PO Box 10602
Portland, OR 97296-0602
Phone (503) 327-4756

Other identifiers 4

IdentifierTypeStateIssuer
858185000OtherORBCBSO
611036100OtherORUS DOL (ACS FISCAL AGENT
3080245-01OtherORFC65, PC65, M/C ADV PPO
9317339OtherORPHCS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041018000372 OR Practitioner - Physical Therapist in Private Practice 4880654490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5909 SE Division St
Suite 3
Portland, OR 97206-1470
Phone (503) 231-3633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4725ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Spine & Body Medicine Physical Therapist CurrentSince Apr 1, 2010 Accepting new patients

Locations

5909 SE Division St
Portland, OR 97206
Phone (503) 231-3633

5909 SE Division St
Ste 3
Portland, OR 97206
Phone (503) 231-3633

Organizations & group practices 1

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1740219500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10602",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972960602",
            "telephone_number": "503-327-4756",
            "fax_number": "503-231-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5909 SE DIVISION ST STE 3",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972061470",
            "telephone_number": "503-231-3633",
            "fax_number": "503-305-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOSTRIN",
        "first_name": "ISRAEL",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSO",
            "identifier": "858185000",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DOL  (ACS FISCAL AGENT",
            "identifier": "611036100",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FC65, PC65, M/C ADV PPO",
            "identifier": "3080245-01",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "9317339",
            "state": "OR"
        }
    ],
    "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 Aug 2, 2023; 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.