MRS. BLAIRE AMANDA FOUBISTER (PT) – Physical Therapist, NPI 1811925340
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,808 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OR
Provider Addresses for MRS. BLAIRE AMANDA FOUBISTER (PT)
147 SW Shevlin Hixon Dr Ste 104
Bend, OR 977023185
Phone: (541) 312-2252
Fax: (541) 312-8822
Type: Location
1454 BAY HARBOR DR
APT #301
PALM HARBOR, FL 346853443
Phone: (727) 644-0409
Type: Mailing
Eastlake Professional Center, 3488, East Lake Road, Palm Harbor, Pinellas County, Florida, 34685, United States
SUITE 302
PALM HARBOR, FL 346852404
Phone: (727) 786-1996
Fax: (727) 789-2111
Type: Location
936 NE PENN AVE
BEND, OR 977014123
Phone: (727) 644-0409
Type: Mailing
2075 NE WYATT CT
BEND, OR 977017686
Phone: (541) 382-5882
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: 2025-02-10
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250210000456 | I | Physical Therapist In Private Practice | OR | TBD |
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.
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 97702)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | CO | |
| Physical Therapist In Private Practice | OR | |
| Physical Therapist In Private Practice | OR | |
| Physical Therapist In Private Practice | OR | |
| Physical Therapist In Private Practice | OR | |
| Physical Therapist In Private Practice | OR |
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