Individual provider Active NPI

Ronald Stibal, PT

  • Physical Therapist
  • Wilsonville, OR
National Provider Identifier
1952597809
Registry record updated Dec 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
06831 Issued in OR
Practice address
25030 SW Parkway Ave Ste 100
Wilsonville, OR 97070-9816
Phone
(503) 582-1073
NPI assigned
Sep 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6831 OR
Physical Therapist 225100000X PT 17941 FL
Physical Therapist 225100000X 06831 OR Primary

Addresses

Primary practice location

25030 SW Parkway Ave Ste 100
Wilsonville, OR 97070-9816

Mailing address

1905 SE 192ND Ave Ste 109
Camas, WA 98607-7415
Phone (360) 210-5440

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121204000200 OR Practitioner - Physical Therapist in Private Practice 5890882229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Motion PLLCGroup PAC ID 6103071014, 30 clinicians

Practice addresses (Care Compare)

15970 SW Tualatin Sherwood Rd
Sherwood, OR 97140-8690
Phone (971) 206-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 17941FLMDPhysical Therapist
06831ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Motion, PLLC Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients
Trinity 5 Inc Physical Therapist PastSince Jul 5, 2020 Accepting new patients
Physical Therapy in Your Home Inc Past Accepting new patients
Advanced Therapy Concepts of Broward Inc Physical Therapist PastSince Jun 2, 2016 Accepting new patients

Locations

1505 NE 40th Ave
Ste C
Portland, OR 97232
Phone (503) 210-1425

15970 SW Tualatin Sherwood Rd
Sherwood, OR 97140
Phone (971) 206-3400

1554 Garden St
Ste 103
West Linn, OR 97068
Phone (503) 582-1073

25030 SW Parkway Ave
Ste 100
Wilsonville, OR 97070
Phone (503) 582-1073

1905 SE 192nd Ave
Ste 109
Camas, WA 98607
Phone (360) 210-5440

Organizations & group practices 4

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": "1190592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735344000000",
    "number": "1952597809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 SE 192ND AVE STE 109",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986077415",
            "telephone_number": "360-210-5440",
            "fax_number": "360-210-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25030 SW PARKWAY AVE STE 100",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709816",
            "telephone_number": "503-582-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIBAL",
        "first_name": "RONALD",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-24",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "6831",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 17941",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "06831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilsonville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2024; 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.