Individual provider Active NPI

Scott B Weber, PT

  • Physical Therapist
  • Bend, OR
National Provider Identifier
1750410221
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4530 Issued in OR
Practice address
336 SW Cyber Dr
Suite 107
Bend, OR 97702-1683
Phone
(541) 382-5500
Fax
(541) 389-5669
NPI assigned
Mar 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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 4530 OR Primary

Addresses

Primary practice location

336 SW Cyber Dr
Suite 107
Bend, OR 97702-1683

Mailing address

PO Box 1517
Pendleton, OR 97801-0410
Phone (877) 708-1119

Other identifiers 1

IdentifierTypeStateIssuer
274010MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031208000844 OR Practitioner - Physical Therapist in Private Practice 0840196374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alpine Physical Therapy and Wellness Center IncGroup PAC ID 5799835435, 8 clinicians

Practice addresses (Care Compare)

2546 NE Conners Ave
Suite 110
Bend, OR 97701-6761
Phone (541) 382-5500

336 SW Cyber Dr
Suite 107
Bend, OR 97702-1682

395 SW Bluff Dr
Suite 10
Bend, OR 97702-1670
Phone (541) 382-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4530ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Physical Therapy and Wellness Center Inc Physical Therapist CurrentSince Jun 29, 2023 Accepting new patients
New Proactive LLC Physical Therapist PastSince Oct 1, 2017 Accepting new patients
Omnis Omnia Inc. PastSince Feb 4, 2015 Accepting new patients

Locations

2698 NE Courtney Dr
Ste 100
Bend, OR 97701
Phone (541) 382-5500

336 SW Cyber Dr
Ste 107
Bend, OR 97702
Phone (541) 382-5500

745 NW Mt Washington Dr
Ste 104
Bend, OR 97703
Phone (541) 382-5500

336 SW Cyber Dr
#D107
Bend, OR 97702
Phone (541) 382-5500

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": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1750410221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010410",
            "telephone_number": "877-708-1119",
            "fax_number": "541-278-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 SW CYBER DR",
            "address_2": "SUITE 107",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021683",
            "telephone_number": "541-382-5500",
            "fax_number": "541-389-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "SCOTT",
        "middle_name": "B",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274010",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.