Individual provider Active NPI

Nancy Ungoco, PT

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1780683318
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3953 Issued in OR
Practice address
4475 SW Scholls Ferry Rd Ste 258
Portland, OR 97225-1958
Phone
(503) 292-5882
Fax
(503) 292-5899
NPI assigned
Jul 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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 3953 OR Primary

Addresses

Primary practice location

4475 SW Scholls Ferry Rd Ste 258
Portland, OR 97225-1958

Mailing address

4475 SW Scholls Ferry Rd Ste 258
Portland, OR 97225-1958
Phone (503) 292-5882

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050518000362 OR Practitioner - Physical Therapist in Private Practice 1759322928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

12345 SW Horizon Blvd
Suite 57
Beaverton, OR 97007-9475
Phone (503) 216-8820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3953ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Physical Therapist CurrentSince Sep 30, 2019 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 30, 2019 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
H & P Goodell, Inc. PastSince Oct 1, 2005 Accepting new patients

Locations

12345 SW Horizon Blvd
Ste 57
Beaverton, OR 97007
Phone (503) 216-8820

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

960 N 16th St
Ste 304
Springfield, OR 97477
Phone (541) 744-6172

Organizations & group practices 4

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": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1780683318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4475 SW SCHOLLS FERRY RD STE 258",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251958",
            "telephone_number": "503-292-5882",
            "fax_number": "503-292-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 SW SCHOLLS FERRY RD STE 258",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251958",
            "telephone_number": "503-292-5882",
            "fax_number": "503-292-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNGOCO",
        "first_name": "NANCY",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "3953",
            "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 17, 2008; 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.