Individual provider Active NPI

Olivia Ellis, PT, DPT

  • Physical Therapist
  • Bend, OR
National Provider Identifier
1861389967
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
65749 Issued in OR
Practice address
371 SW Upper Terrace Dr Ste 3
Bend, OR 97702-1560
Phone
(541) 316-0805
Fax
(541) 241-7670
NPI assigned
Jun 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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 65749 OR Primary

Addresses

Primary practice location

371 SW Upper Terrace Dr Ste 3
Bend, OR 97702-1560

Mailing address

371 SW Upper Terrace Dr Ste 3
Bend, OR 97702-1560
Phone (541) 316-0805

Other practice location 1

392 W Main Ave
Sisters, OR 97759-0439
Phone (541) 316-0805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250826000006 OR Practitioner - Physical Therapist in Private Practice 5890295638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspire Physical Therapy LLCGroup PAC ID 1850707316, 7 clinicians

Practice addresses (Care Compare)

371 SW Upper Terrace Dr
Suite 3
Bend, OR 97702-1560
Phone (541) 316-0805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Physical Therapy LLC Physical Therapist CurrentSince Aug 11, 2025 Accepting new patients
Aspire Physical Therapy LLC Physical Therapist CurrentSince Aug 11, 2025 Accepting new patients

Locations

371 SW Upper Terrace Dr
Ste 3
Bend, OR 97702
Phone (541) 316-0805

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1861389967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 SW UPPER TERRACE DR STE 3",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021560",
            "telephone_number": "541-316-0805",
            "fax_number": "541-241-7670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 SW UPPER TERRACE DR STE 3",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021560",
            "telephone_number": "541-316-0805",
            "fax_number": "541-241-7670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "392 W Main Ave",
            "address_purpose": "LOCATION",
            "city": "Sisters",
            "state": "OR",
            "postal_code": "977590439",
            "country_code": "US",
            "telephone_number": "541-316-0805",
            "fax_number": "541-241-7670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "OLIVIA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "65749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 20, 2025; 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.