Individual provider Active NPI

Michael Aaron Schwentner

  • Physical Therapy Assistant
  • Medford, OR
National Provider Identifier
1932715612
Registry record updated Sep 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
9873 Issued in OR
Practice address
835 Crater Lake Ave
Medford, OR 97504-6505
Phone
(541) 773-7717
NPI assigned
Sep 18, 2020
Last updated
Sep 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 9873 OR Primary

Addresses

Primary practice location

835 Crater Lake Ave
Medford, OR 97504-6505

Mailing address

2311 Oakway Ter
Eugene, OR 97401-5109
Phone (503) 877-7776

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260126000492 OR Practitioner - Physical Therapist in Private Practice 1355828906 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
South Lane Physical Therapy LLCGroup PAC ID 4981929320, 3 clinicians

Practice addresses (Care Compare)

75 Gateway Blvd
Suite a
Cottage Grove, OR 97424-1740
Phone (541) 942-6482

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9873ORMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
South Lane Physical Therapy LLC CurrentSince Dec 21, 2025 Accepting new patients

Locations

303 E Main St
Cottage Grove, OR 97424
Phone (541) 761-2750

75 Gateway Blvd
Ste A
Cottage Grove, OR 97424
Phone (541) 942-6482

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1932715612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 OAKWAY TER",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974015109",
            "telephone_number": "503-877-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 CRATER LAKE AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046505",
            "telephone_number": "541-773-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWENTNER",
        "first_name": "MICHAEL",
        "middle_name": "AARON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "9873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.