NPIMap

Organization Active NPI

Osprey Physical Therapy and Sports Medicine, LLC.

  • Physical Medicine & Rehabilitation Physician
  • Bend, OR
National Provider Identifier
1831706308
Registry record updated Jan 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
OSPREY PHYSICAL THERAPY AND SPORTS MEDICINE, LLC.
Practice address
558 SE 9TH St Ste 5
Bend, OR 97702-2265
Phone
(541) 647-7332
Fax
(541) 640-5541
NPI assigned
Sep 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2025

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

Authorized official

Name
Carol Roeder, DPTNPI 1174983415
Title
Owner/Physical Therapist
Phone
(541) 647-7332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208100000X Primary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X

Addresses

Primary practice location

558 SE 9TH St Ste 5
Bend, OR 97702-2265

Mailing address

558 SE 9TH St Ste 5
Bend, OR 97702-2265
Phone (541) 647-7332

Other practice location 1

909 SE 2nd St Ste B
Bend, OR 97702-1756
Phone (541) 647-7332

Other names 1

  • Osprey Physical Therapy and Sports Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201106002119 OR Part B Supplier - Clinic/Group Practice 3971913609 Receives reassigned benefits from 5 practitioners
Practice locations: Bend, OR

National Provider Directory

National Provider Directory

Locations

909 SE 2nd St
Ste B
Bend, OR 97702
Phone (541) 410-3428

155 SW Century Dr
Ste 110
Bend, OR 97702
Phone (541) 647-7332

558 SE 9th St
Ste 5
Bend, OR 97702
Phone (541) 410-3428

Practitioners & affiliated clinicians

Practitioners 5

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": "1601251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737158400000",
    "number": "1831706308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 SE 9TH ST STE 5",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022265",
            "telephone_number": "541-647-7332",
            "fax_number": "541-640-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 SE 9TH ST STE 5",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022265",
            "telephone_number": "541-647-7332",
            "fax_number": "541-640-5541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 SE 2nd St Ste B",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977021756",
            "country_code": "US",
            "telephone_number": "541-647-7332",
            "fax_number": "541-640-5541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OSPREY PHYSICAL THERAPY AND SPORTS MEDICINE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-28",
        "last_updated": "2025-01-18",
        "certification_date": "2025-01-18",
        "status": "A",
        "authorized_official_last_name": "ROEDER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "541-647-7332",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Osprey Physical Therapy and Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 18, 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.