Active NPI
Aegis Group Practice LLC
- Physical Therapist
- Beaverton, OR
National Provider Identifier
1922803402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 5450 SW Erickson Ave
Beaverton, OR 97005-4018 - Phone
- (479) 201-6091
- NPI assigned
- Feb 18, 2025
- Last updated
- Feb 18, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tracy McCall
- Title
- Credentialing
- Phone
- (479) 201-6091
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NU | Primary | |
| Occupational Therapist | 225X00000X | NU | ||
| Speech-Language Pathologist | 235Z00000X | NU |
Addresses
Primary practice location
5450 SW Erickson Ave
Beaverton, OR 97005-4018
Mailing address
4933 Old Greenwood Rd
Fort Smith, AR 72903-6906
Phone (479) 201-6091
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230607003040 | OR | Part B Supplier - Clinic/Group Practice | 5193036432 |
Receives reassigned benefits from 12 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Beaverton, OR; Bend, OR; Lake Oswego, OR; Sherwood, OR |
Other NPIs on the same Medicare enrollment 6
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Marguerite Thompson PT
Organizations with this tax ID in the same state 4
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Physical Therapist
- Happy Valley, OR
- NPI 1265203046
-
- Physical Therapist
- Sherwood, OR
- NPI 1356134951
-
- Physical Therapist
- Lake Oswego, OR
- NPI 1598529778
-
- Physical Therapist
- Bend, OR
- NPI 1932891363
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739836800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1739836800000",
"number": "1922803402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4933 OLD GREENWOOD RD",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729036906",
"telephone_number": "479-201-6091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5450 SW ERICKSON AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970054018",
"telephone_number": "479-201-6091"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AEGIS GROUP PRACTICE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-02-18",
"last_updated": "2025-02-18",
"certification_date": "2025-02-18",
"status": "A",
"authorized_official_last_name": "MCCALL",
"authorized_official_first_name": "TRACY",
"authorized_official_title_or_position": "CREDENTIALING",
"authorized_official_telephone_number": "479-201-6091"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.