Kevin M Pust, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

61068 Issued in OR

Practice address

1630 Beavercreek Rd
Suite a
Oregon City, OR 97045-4156

Phone

(503) 489-6250

Fax

(503) 489-1650

NPI assigned

May 28, 2015

Last updated

May 28, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, AK2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Proactive LLCGroup PAC ID 7315218708, 53 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• New Proactive LLC

  dba ProActive Physical Therapy

  • Physical Therapy Clinic/Center
  • Oregon City, OR
  • NPI 1396273199

  WA

  Medicare reassignment Care Compare group
• Adient Alaska, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Fairbanks, AK
  • NPI 1669796108
  Medicare reassignment NPD

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1831578400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 NE VILLAGE ST",
            "city": "FAIRVIEW",
            "state": "OR",
            "postal_code": "970243827",
            "telephone_number": "503-489-6250",
            "fax_number": "503-489-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 BEAVERCREEK RD",
            "address_2": "SUITE A",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454156",
            "telephone_number": "503-489-6250",
            "fax_number": "503-489-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUST",
        "first_name": "KEVIN",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-28",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "61068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shayna Pukini, CADC REGISTRANT
• Julia Lee Charmayne Pulliam, PA
• Pure Health Natural Medicine LLC
• Purely Primal Physical Therapy & Wellness, LLC
• Dreana Mae Purington, CADC1
• Anna N Putnam
• Ellen Pyle
• Ariana Quakenbush, LMT,NMMT
• Quest Center Clackamas (Quest Center for Integrative Health)
• Candace Quinn, RN

• Physical Therapist in Oregon City, OR
• Providers in Oregon City, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; 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.