Individual provider Active NPI

Brycen Jared Lee, PT, DPT

  • Physical Therapist
  • Oregon City, OR
National Provider Identifier
1942090584
Registry record updated May 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
65718 Issued in OR
Practice address
1630 Beavercreek Rd Ste a
Oregon City, OR 97045-4156
Phone
(503) 607-0047
NPI assigned
May 7, 2025
Last updated
May 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2025

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 65718 OR Primary

Addresses

Primary practice location

1630 Beavercreek Rd Ste a
Oregon City, OR 97045-4156

Mailing address

25636 SW Canyon Creek Rd Apt R101
Wilsonville, OR 97070-5662
Phone (808) 397-3777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250611000788 OR Practitioner - Physical Therapist in Private Practice 3870003502 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
New Proactive LLCGroup PAC ID 7315218708, 53 clinicians

Practice addresses (Care Compare)

1630 Beavercreek Rd
Suite a
Oregon City, OR 97045-4156
Phone (503) 607-0047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
65718ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Proactive LLC Physical Therapist CurrentSince May 29, 2025 Accepting new patients
Omnis Omnia Inc. PastSince Feb 4, 2015 Accepting new patients

Locations

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

1630 Beavercreek Rd
Ste A
Oregon City, OR 97045
Phone (503) 607-0047

450 NW Greenwood Ave
Redmond, OR 97756
Phone (541) 923-0410

Organizations & group practices 2

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": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748217600000",
    "number": "1942090584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25636 SW CANYON CREEK RD APT R101",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970705662",
            "telephone_number": "808-397-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 BEAVERCREEK RD STE A",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454156",
            "telephone_number": "503-607-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BRYCEN",
        "middle_name": "JARED",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-07",
        "last_updated": "2025-05-26",
        "certification_date": "2025-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "65718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2025; 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.