FARAH GRACE CUSTODIO – Orthopedic Physical Therapist, NPI 1740924620

FARAH GRACE CUSTODIO is a healthcare provider. based in Portland, Oregon. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 64412 (OR). The NPI Number for FARAH GRACE CUSTODIO is 1740924620

Main info

Female
Sole Proprietor
21 Years Of Experience
Accepts Medicare Assignment
Name
FARAH GRACE CUSTODIO
NPI
1740924620
Phone
(503) 804-1072
Address
1000 NW 123RD AVE APT 1
Enumeration Date
26 April 2022
Last Update Date
22 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5033571706
Graduation Year
2005 (21 years ago)
PAC ID
9133507759
Group Practice PAC ID
0941365514
Professional Enrollment ID
I20220609001155
Address ID
OR971162224FO3838XAVEX300

Contacts

SOAP Endpoint
OREGON
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Other namesUpdated within 12 months

1,808 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OR

Provider Addresses for FARAH GRACE CUSTODIO

  • 1000 NW 123RD AVE APT 1

    PORTLAND, OR 972295673

    Phone: (503) 804-1072

    Type: Mailing

  • 3838 PACIFIC AVE

    FOREST GROVE, OR 971162224

    Phone: (503) 357-1706

    Type: Location

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: 2022-06-09

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
I20220609001155IPhysical 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities1,28264$0
97140Therapy procedure using manual technique, each 15 minutes16540$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes7519$0
97164Re-evaluation for physical therapy, typically 20 minutes5226$0
97162Evaluation for physical therapy, typically 30 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 97229)

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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: 0941365514View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
-OR
Physical Therapist In Private PracticeOR

Reviews

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Frequently asked questions

Can I cross-check FARAH GRACE CUSTODIO using NPI 1740924620?
NPI 1740924620 belongs to FARAH GRACE CUSTODIO; compare other details if you need extra assurance.
Is there an active status for FARAH GRACE CUSTODIO?
For scheduling context, FARAH GRACE CUSTODIO is shown as active in the registry.
How would a patient describe FARAH GRACE CUSTODIO's focus?
For FARAH GRACE CUSTODIO, the primary taxonomy reads as Orthopedic Physical Therapist. Clinical services aligned with this taxonomy classification.
Is FARAH GRACE CUSTODIO located near Portland?
FARAH GRACE CUSTODIO currently maps to Portland, Oregon in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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