ALLISON SAM (DPT) – Physical Therapist, NPI 1093550196

ALLISON SAM (DPT) is a healthcare provider. based in Portland, Oregon. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. The NPI Number for ALLISON SAM (DPT) is 1093550196

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
ALLISON SAM (DPT)
NPI
1093550196
Phone
Not provided
Address
5212 SE 52ND AVE
Enumeration Date
28 June 2024
Last Update Date
28 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5037771983
Graduation Year
2024 (2 years ago)
PAC ID
1658818836
Group Practice PAC ID
2860437027
Professional Enrollment ID
I20240806001155
Address ID
OR972065629PO5212XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience17
Completeness75
Years active:1State licenses:0Digital endpointsOther names

1,808 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OR

Provider Addresses for ALLISON SAM (DPT)

  • 5212 SE 52ND AVE

    PORTLAND, OR 972065629

    Phone:

    Mailing address matches the actual address.

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: 2024-08-06

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
I20240806001155IPhysical Therapist In Private PracticeORTBD

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 97206)

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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: 2860437027View full group profile
NameSpecialtyState
-OK
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeCA

Reviews

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Frequently asked questions

Can I verify ALLISON SAM (DPT) with an NPI only?
You can start verification with NPI 1093550196 for ALLISON SAM (DPT), then check state licensing separately.
Does the file indicate ALLISON SAM (DPT) is practicing under active NPI?
Directory data currently reports ALLISON SAM (DPT) as active.
What taxonomy line describes ALLISON SAM (DPT)?
For research purposes, treat ALLISON SAM (DPT) as Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Does ALLISON SAM (DPT) list a practice location?
Patients near Portland, Oregon may find ALLISON SAM (DPT) in results; validate coverage separately.
Is the information about ALLISON SAM (DPT) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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