Individual provider Active NPI

Ellie R Meyrowitz, PT

  • Physical Therapist
  • Bend, OR
National Provider Identifier
1811218720
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
04880 Issued in OR
Practice address
1160 SW Simpson Ave
Ste 200
Bend, OR 97702-3542
Phone
(541) 322-9045
Fax
(541) 322-9044
NPI assigned
Jun 15, 2010
Last updated
Mar 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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 04880 OR Primary

Addresses

Primary practice location

1160 SW Simpson Ave
Ste 200
Bend, OR 97702-3542

Mailing address

805 SW Industrial Way
Ste 3
Bend, OR 97702-1093
Phone (541) 585-2529

Other identifiers 1

IdentifierTypeStateIssuer
500623056MedicaidOR

Other names 1

  • Ellie R Lallman Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101213001060 OR Practitioner - Physical Therapist in Private Practice 1850587288 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04880ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rebound Physical Therapy Limited Partnership Physical Therapist CurrentSince Mar 1, 2016 Accepting new patients
Rebound Physical Therapy Limited Partnership Physical Therapist CurrentSince Mar 1, 2016 Accepting new patients
Erhardt Physical Therapy and Sports Medicine, LLC Physical Therapist PastSince Jun 29, 2016 Accepting new patients

Locations

1160 SW Simpson Ave
Ste 200
Bend, OR 97702
Phone (541) 322-9045

805 SW Industrial Way
Ste 3
Bend, OR 97702
Phone (541) 323-5864

1315 NW 4th St
Apt B
Redmond, OR 97756
Phone (541) 504-2350

1717 NE 2nd St
Redmond, OR 97756
Phone (541) 332-9045

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1811218720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SW INDUSTRIAL WAY",
            "address_2": "STE 3",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021093",
            "telephone_number": "541-585-2529",
            "fax_number": "541-585-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 SW SIMPSON AVE",
            "address_2": "STE 200",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023542",
            "telephone_number": "541-322-9045",
            "fax_number": "541-322-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYROWITZ",
        "first_name": "ELLIE",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "04880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500623056",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLIE",
            "last_name": "LALLMAN",
            "middle_name": "R",
            "credential": "PT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.