Individual provider Active NPI

Nicolette Sapigao, DPT

  • Physical Therapist
  • Redmond, OR
National Provider Identifier
1992048532
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
63655 Issued in OR
Practice address
1315 NW 4TH St Apt B
Redmond, OR 97756-1328
Phone
(541) 504-2350
Fax
(541) 504-2354
NPI assigned
Apr 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 38190 CA
Physical Therapist 225100000X 63655 OR Primary

Addresses

Primary practice location

1315 NW 4TH St Apt B
Redmond, OR 97756-1328

Mailing address

805 SW Industrial Way Ste 3
Bend, OR 97702-1093
Phone (541) 504-2350

Other practice location 1

11211 Exeter St
Loma Linda, CA 92354-3006
Phone (909) 289-0089

Other names 1

  • Nicolette Harris Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201221002004 OR Practitioner - Physical Therapist in Private Practice 5890107502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rebound Physical Therapy Limited PartnershipGroup PAC ID 4880990753, 38 clinicians

Practice addresses (Care Compare)

1315 NW 4TH St
Apt B
Redmond, OR 97756-1328
Phone (541) 504-2350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38190CAMDGeneral Practice Dentistry
63655ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rebound Physical Therapy Limited Partnership Physical Therapist CurrentSince Nov 1, 2020 Accepting new patients
Rebound Physical Therapy Limited Partnership Physical Therapist CurrentSince Nov 1, 2020 Accepting new patients

Locations

805 SW Industrial Way
Ste 3
Bend, OR 97702
Phone (541) 323-5864

1315 NW 4th St
Apt B
Redmond, OR 97756
Phone (541) 504-2350

1717 NE 2nd St
Redmond, OR 97756
Phone (541) 332-9045

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": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1992048532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SW INDUSTRIAL WAY STE 3",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021093",
            "telephone_number": "541-504-2350",
            "fax_number": "541-504-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 NW 4TH ST APT B",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561328",
            "telephone_number": "541-504-2350",
            "fax_number": "541-504-2354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11211 Exeter St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923543006",
            "country_code": "US",
            "telephone_number": "909-289-0089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAPIGAO",
        "first_name": "NICOLETTE",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-02",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "38190",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "63655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLETTE",
            "last_name": "HARRIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.