Individual provider Active NPI

Benjamin Richards, DPT

  • Physical Therapist
  • Beaverton, OR
National Provider Identifier
1790421964
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
64493 Issued in OR
Practice address
12345 SW Horizon Blvd Ste 57
Beaverton, OR 97007-9475
Phone
(503) 216-8825
NPI assigned
May 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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 64493 OR Primary

Addresses

Primary practice location

12345 SW Horizon Blvd Ste 57
Beaverton, OR 97007-9475

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other practice location 1

1630 Beavercreek Rd Ste A
Oregon City, OR 97045-4156
Phone (503) 607-0047

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221107000960 OR Practitioner - Physical Therapist in Private Practice 9830566736 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
New Proactive LLC Physical Therapist CurrentSince Jul 10, 2022 Accepting new patients
Providence Health & Services Oregon CurrentSince May 5, 2025 Accepting new patients
Providence Health & Services - Oregon Physical Therapist CurrentSince May 5, 2025 Accepting new patients

Locations

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

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

1630 Beavercreek Rd
Ste A
Oregon City, OR 97045
Phone (503) 607-0047

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": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1790421964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12345 SW HORIZON BLVD STE 57",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970079475",
            "telephone_number": "503-216-8825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1630 Beavercreek Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970454156",
            "country_code": "US",
            "telephone_number": "503-607-0047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "BENJAMIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-10",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.