Individual provider Active NPI

Bradley Ehrenfelt

  • Physical Therapist
  • Bend, OR
National Provider Identifier
1912678152
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
64223 Issued in OR
Practice address
55 NW Wall Street Ste #100
Optional
Bend, OR 97703
Phone
(541) 389-4321
NPI assigned
Sep 27, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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 64223 OR Primary

Addresses

Primary practice location

55 NW Wall Street Ste #100
Optional
Bend, OR 97703

Mailing address

55 NW Wall Street Ste #100
Optional
Bend, OR 97703
Phone (541) 389-4321

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211022000799 OR Practitioner - Physical Therapist in Private Practice 2567850696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

974 SW Veterans Way
Suite 4
Redmond, OR 97756-2564
Phone (541) 504-5363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64223ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy of Oregon LLC Physical Therapist CurrentSince Jan 6, 2024 Accepting new patients
Benchmark Physical Therapy of Oregon LLC Physical Therapist Current Accepting new patients
Benchmark Physical Therapy of Or, LLC Physical Therapist CurrentSince Jan 6, 2024 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

3007 NE West Devils Lake Rd
Lincoln City, OR 97367
Phone (541) 994-6252

3512 Excel Dr
Ste 105
Medford, OR 97504
Phone (541) 245-0419

974 SW Veterans Way
Ste 4
Redmond, OR 97756
Phone (541) 504-2350

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1912678152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 NW WALL STREET STE #100",
            "address_2": "OPTIONAL",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97703",
            "telephone_number": "541-389-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 NW WALL STREET STE #100",
            "address_2": "OPTIONAL",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97703",
            "telephone_number": "541-389-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRENFELT",
        "first_name": "BRADLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64223",
            "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 Sep 27, 2021; 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.