NPIMap

Organization Active NPI

Progressive Rehabilitation Associates LLC

  • Clinic/Center
  • Portland, OR
National Provider Identifier
1790760908
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
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
Last updated
Mar 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
O20040413001850 OR Part B Supplier - Clinic/Group Practice 3476547258 Receives reassigned benefits from 22 practitioners
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1815 SW Marlow Ave
Ste 110
Portland, OR 97225
Phone (503) 292-0765

4949 S Macadam Ave
Portland, OR 97239
Phone (800) 273-9292

4949 S Macadam Ave
Ste 90
Portland, OR 97239

8716 E Mill Plain Blvd
Vancouver, WA 98664
Phone (360) 514-4325

Practitioners & affiliated clinicians

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 51

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.

Verify at the official NPI Registry.