Individual provider Active NPI

Ian McVay, PTA

  • Physical Therapy Assistant
  • Portland, OR
National Provider Identifier
1780031120
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
9925 Issued in OR
Practice address
7412 SW Beaverton Hillsdale Hwy Ste 110
Portland, OR 97225-2167
Phone
(503) 616-0313
NPI assigned
May 16, 2016
Last updated
Aug 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 9925 OR Primary

Addresses

Primary practice location

7412 SW Beaverton Hillsdale Hwy Ste 110
Portland, OR 97225-2167

Mailing address

6244 SW 208TH Ter
Beaverton, OR 97078-8695
Phone (760) 641-1721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9925ORMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ipa Physio Portland LLC CurrentSince Sep 5, 2023 Accepting new patients

Locations

7412 SW Beaverton Hillsdale Hwy
Ste 110
Portland, OR 97225
Phone (503) 616-0313

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, 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": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1780031120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6244 SW 208TH TER",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970788695",
            "telephone_number": "760-641-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7412 SW BEAVERTON HILLSDALE HWY STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972252167",
            "telephone_number": "503-616-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCVAY",
        "first_name": "IAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-16",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "9925",
            "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 Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.