RIVERSIDE PHYSICAL THERAPY – Physical Therapist, NPI 1467636654
Physical Therapist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for RIVERSIDE PHYSICAL THERAPY
1701, Northwest Hawthorne Avenue, Grants Pass, Josephine County, Oregon, 97526, United States
#103
GRANTS PASS, OR 975261257
Phone: (541) 476-2502
Fax: (541) 476-2397
Type: Mailing
415, South Main Street, Canyonville, Douglas County, Oregon, 97417, United States
CANYONVILLE, OR 974179646
Phone: (541) 839-4998
Fax: (541) 839-4999
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.
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 |
|---|---|---|---|---|
| O20040116000412 | O | Clinic/Group 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 97526)
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