Active NPI
Progressive Rehabilitation Associates LLC
- Clinic/Center
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- PROGRESSIVE REHABILITATION ASSOCIATES LLC
- Practice address
- 4640 S Macadam Ave Ste 90
Portland, OR 97239-4285 - Phone
- (503) 292-0765
- Fax
- (503) 292-5208
- NPI assigned
- Dec 9, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Margaret S Pemberton
- Title
- Vice President & Manager
- Phone
- (502) 394-2100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
4640 S Macadam Ave Ste 90
Portland, OR 97239-4285
Mailing address
1815 SW Marlow Ave
Suite 110
Portland, OR 97225-5185
Phone (503) 292-0765
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040413001850 | OR | Part B Supplier - Clinic/Group Practice | 3476547258 |
Receives reassigned benefits from 22 practitioners Practice locations: Portland, OR |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
4949 S Macadam Ave
Ste 90
Portland, OR 97239
1815 SW Marlow Ave
Portland, OR 97225
Phone (503) 292-0765
4640 S Macadam Ave
Ste 90
Portland, OR 97239
Phone (503) 292-0765
406 SE 131st Ave
Vancouver, WA 98683
Phone (360) 921-0981
Practitioners & affiliated clinicians
Practitioners 49
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134086400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1741651200000",
"number": "1790760908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1815 SW MARLOW AVE",
"address_2": "SUITE 110",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972255185",
"telephone_number": "503-292-0765",
"fax_number": "503-292-5208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4640 S MACADAM AVE STE 90",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394285",
"telephone_number": "503-292-0765",
"fax_number": "503-292-5208"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROGRESSIVE REHABILITATION ASSOCIATES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-12-09",
"last_updated": "2025-03-11",
"certification_date": "2025-03-11",
"status": "A",
"authorized_official_last_name": "PEMBERTON",
"authorized_official_first_name": "MARGARET",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "VICE PRESIDENT & MANAGER",
"authorized_official_telephone_number": "502-394-2100",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"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 Mar 11, 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.