Phillip Edwin Segura Jr.
Individual provider Active NPI Physical Therapist · Monmouth, OR
NPI 1972138535 · NPPES record last updated Mar 4, 2020
Key facts
- NPI
- 1972138535
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1977 (OR)
- Practice address
- 512 Main St E
Monmouth, OR 97361-2369 - Phone
- (503) 838-1388
- NPI assigned
- Mar 4, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Salem Health
Practice addresses (Care Compare)
1000 SE Uglow Ave
Dallas, OR 97338-2645
Phone (503) 623-8376
512 Main St E
Suite 300
Monmouth, OR 97361-2370
Phone (503) 838-1182
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200515001494 | OR | Practitioner - Physical Therapist in Private Practice | 6103257621 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1977 | OR | MD | Naturopath |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Salem Health | Current |
Accepting new patients | |
| Salem Health | Current |
Accepting new patients | |
| Salem Health | Current |
Accepting new patients | |
| Salem Health West Valley | Current |
Accepting new patients |
Locations
1000 SE Uglow Ave
Dallas, OR 97338
Phone (503) 623-8376
1601 Monmouth St
Ste 100
Independence, OR 97351
Phone (503) 623-8301
512 Main St E
Ste 300
Monmouth, OR 97361
Phone (503) 838-1182
512 Main St E
Monmouth, OR 97361
Phone (503) 838-1182
665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1977 | OR | Yes |
Addresses
Primary practice location
512 Main St E
Monmouth, OR 97361-2369
Mailing address
PO Box 13129
Salem, OR 97309-1129
Other providers in Monmouth, OR
- Natasha Ruegsegger
- Salem Health
- Joshua Fitzgerald Sandeman
- Rachael Lynne Schmelling
- Elizabeth Scroggins
- John David Shurtz
- Christopher McCarthy Silva
- Wesley Stoecker
- Thomas Wayne Stutzman
- Jairo Emanuel Sun
All providers in Monmouth, OR · Physical Therapist in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.