Individual provider Active NPI

Megan Jo Gabourel, DPT

  • Orthopedic Physical Therapist
  • Portland, OR
National Provider Identifier
1790337152
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT63231 Issued in OR
Practice address
11782 SW Barnes Rd Ste 100
Portland, OR 97225-5931
Phone
(503) 906-4323
Fax
(503) 906-4333
NPI assigned
Jul 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT63231 OR Primary

Addresses

Primary practice location

11782 SW Barnes Rd Ste 100
Portland, OR 97225-5931

Mailing address

11782 SW Barnes Rd Ste 100
Portland, OR 97225-5931
Phone (503) 906-4323

Other identifiers 1

IdentifierTypeStateIssuer
PT63231OtherORPT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231016001706 WA Practitioner - Physical Therapist in Private Practice 0547597312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

730 N Hamilton St
Spokane, WA 99202-2045
Phone (509) 458-7686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT63231ORMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
U District Physical Therapy and Institute of Sports Performance CurrentSince Sep 1, 2023 Accepting new patients

Locations

730 N Hamilton St
Spokane, WA 99202
Phone (509) 458-7686

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": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1790337152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11782 SW BARNES RD STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255931",
            "telephone_number": "503-906-4323",
            "fax_number": "503-906-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11782 SW BARNES RD STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255931",
            "telephone_number": "503-906-4323",
            "fax_number": "503-906-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABOUREL",
        "first_name": "MEGAN",
        "middle_name": "JO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OR",
            "license": "PT63231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT63231",
            "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 Jul 15, 2019; 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.