Active NPI
Ivan Sultan, MPT
- Physical Therapist
- Astoria, OR
National Provider Identifier
1871506659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6705
- Practice address
- 2265 Exchange St
Astoria, OR 97103-3331 - Phone
- (503) 338-4005
- Fax
- (503) 338-7557
- NPI assigned
- Aug 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6705 | OR | Primary |
Addresses
Primary practice location
2265 Exchange St
Astoria, OR 97103-3331
Mailing address
748 15TH St
Astoria, OR 97103-3824
Phone (503) 468-2469
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6705 | OR | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373846400000",
"number": "1871506659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "748 15TH ST",
"city": "ASTORIA",
"state": "OR",
"postal_code": "971033824",
"telephone_number": "503-468-2469",
"fax_number": "503-338-7557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2265 EXCHANGE ST",
"city": "ASTORIA",
"state": "OR",
"postal_code": "971033331",
"telephone_number": "503-338-4005",
"fax_number": "503-338-7557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULTAN",
"first_name": "IVAN",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2013-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "6705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Astoria, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.