Individual provider Active NPI

Justin Melson

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1972906345
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60799 Issued in OR
Practice address
11782 SW Barnes Rd Ste 300
Portland, OR 97225-5933
Phone
(503) 258-0717
NPI assigned
Sep 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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 60799 OR Primary

Addresses

Primary practice location

11782 SW Barnes Rd Ste 300
Portland, OR 97225-5933

Mailing address

12518 NE Airport Way Ste 110
Portland, OR 97230-1090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170501001329 OR Practitioner - Physical Therapist in Private Practice 4284911223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic and Fracture Clinic PCGroup PAC ID 1052219953, 56 clinicians

Practice addresses (Care Compare)

11782 SW Barnes Rd
Suite 300
Portland, OR 97225-5933
Phone (503) 214-5200

Merit-based Incentive Payment System (MIPS)

Final score
54.33 of 100Reported as group
Quality
57.12
Promoting interoperability
0
Improvement activities
30
Cost
86.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen a Mitchell Physical Therapist PastSince May 1, 2017 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1972906345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12518 NE AIRPORT WAY STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972301090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11782 SW BARNES RD STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255933",
            "telephone_number": "503-258-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELSON",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-30",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.