SUE ELLEN STEWART (PT) – Physical Therapist, NPI 1780795120

SUE ELLEN STEWART (PT) is a healthcare provider. based in Tigard, Oregon. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 0960 (OR). The NPI Number for SUE ELLEN STEWART (PT) is 1780795120

Main info

Female
47 Years Of Experience
Name
SUE ELLEN STEWART (PT)
NPI
1780795120
Phone
(503) 974-9078
Address
12540 SW 68TH AVE
Enumeration Date
31 August 2006
Last Update Date
31 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5039749078
Graduation Year
1979 (47 years ago)
PAC ID
6800030842
Group Practice PAC ID
9537302245
Professional Enrollment ID
I20130913000254
Address ID
OR97223XXXXTIXXXXXXXXXX00
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,808 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OR

Provider Addresses for SUE ELLEN STEWART (PT)

  • 12540 SW 68TH AVE

    TIGARD, OR 972238597

    Phone: (503) 974-9078

    Fax: (503) 974-9083

    Type: Mailing

  • HealthSource America's Chiropractor, 17120, Pilkington Road, Cook, Jean, Lake Oswego, Clackamas County, Oregon, 97035, United States

    LAKE OSWEGO, OR 970355353

    Phone: (503) 974-9078

    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: 2013-09-13

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
I20130913000254IPhysical 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 activities37016$0
97140Therapy procedure using manual technique, each 15 minutes10615$0
View full utilization report →

Insurance plans in this area (ZIP 97223)

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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: 9537302245View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
-OR

Reviews

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Frequently asked questions

What identifier follows SUE ELLEN STEWART (PT) across health systems?
The NPI 1780795120 uniquely identifies SUE ELLEN STEWART (PT) in U.S. healthcare data.
Does the public listing show SUE ELLEN STEWART (PT) as active?
SUE ELLEN STEWART (PT)'s NPI record reflects an active status in NPPES.
What type of care does SUE ELLEN STEWART (PT) provide?
SUE ELLEN STEWART (PT)'s profile centers on Physical Therapist. Clinical services aligned with this taxonomy classification.
Which community is linked to SUE ELLEN STEWART (PT)?
SUE ELLEN STEWART (PT) shows a connection to Tigard, Oregon in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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