ELIZABETH GRACE ROOSMA (PT) – Physical Therapist, NPI 1043669302

ELIZABETH GRACE ROOSMA (PT) is a healthcare provider. based in Coos bay, Oregon. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 61677 (OR). The NPI Number for ELIZABETH GRACE ROOSMA (PT) is 1043669302

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
ELIZABETH GRACE ROOSMA (PT)
NPI
1043669302
Phone
(541) 266-3658
Address
2645 N 17TH ST
Enumeration Date
8 June 2016
Last Update Date
20 September 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5097544631
Graduation Year
2013 (13 years ago)
PAC ID
2466746714
Group Practice PAC ID
6709775166
Professional Enrollment ID
I20240220004276
Address ID
WA988231997EP200XXWAYX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:9State licenses:1Digital endpointsOther names

1,808 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OR

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Provider Addresses for ELIZABETH GRACE ROOSMA (PT)

  • 2645, North 17th Street, Coos Bay, Coos County, Oregon, 97420, United States

    COOS BAY, OR 974202134

    Phone: (541) 266-3658

    Fax: (541) 267-5395

    Type: Mailing

  • 200 NAT WASHINGTON WAY

    EPHRATA, WA 988231997

    Phone: (509) 754-4631

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240220004276IPhysical Therapist In Private PracticeWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97420)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709775166View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology)WA
Physical Therapist In Private PracticeWA
Physician AssistantWA
Diagnostic RadiologyWA
Physical Therapist In Private PracticeWA
Qualified Speech Language PathologistOK
Occupational Therapist In Private PracticeCA
Physician AssistantFL
Diagnostic RadiologyWA
Diagnostic RadiologyNC

Reviews

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Frequently asked questions

What is the 10-digit NPI for ELIZABETH GRACE ROOSMA (PT)?
ELIZABETH GRACE ROOSMA (PT) — NPI 1043669302 — is the standard way to identify this listing.
Does the file indicate ELIZABETH GRACE ROOSMA (PT) is practicing under active NPI?
Directory data currently reports ELIZABETH GRACE ROOSMA (PT) as active.
What healthcare role does ELIZABETH GRACE ROOSMA (PT) hold?
Scheduling teams often label ELIZABETH GRACE ROOSMA (PT) under Physical Therapist. Clinical services aligned with this taxonomy classification.
Where should I expect ELIZABETH GRACE ROOSMA (PT) on a map?
Expect Coos Bay, Oregon as a primary anchor for ELIZABETH GRACE ROOSMA (PT) unless the record lists multiple sites.
Why does ELIZABETH GRACE ROOSMA (PT) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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