Ishani Shah

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

62701 Issued in OR

Practice address

377 NW Jasper St
Dallas, OR 97338-1279

Phone

(503) 623-5581

NPI assigned

Apr 6, 2021

Last updated

Apr 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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 CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pleasanton Physical Therapy Services IncGroup PAC ID 4284690694, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Pleasanton Physical Therapy Services, Inc.

  dba Back on Track Physical Therapy

  • Physical Therapist
  • Pleasanton, CA
  • NPI 1336295138
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1922687912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25764 SW CANYON CREEK RD APT B201",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970705622",
            "telephone_number": "909-809-1504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 NW JASPER ST",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381279",
            "telephone_number": "503-623-5581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ISHANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harry Bret Schumilas, MD
• Jessica Irene Scovell, LMT
• Michael Joseph Sedlock, NA
• Julie Segura, PT
• Anna U Severin, PA
• Linda Leann Shannon, LCSW
• Faith Renee Shinn, FNP-C
• Rachel Nicole Shultz, QMHA 2, CADC 2
• Hollie Louise Simes, APRN
• Stephanie Sireix, MS, LPC, CADC I

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.