Amy Mangum, LOTR is a medicare enrolled "Occupational Therapist" provider in Portland, Oregon. Her current practice location is
1815 Sw Marlow Ave Ste 110, Portland, Oregon. You can reach out to her office (for appointments etc.) via phone at
(503) 292-0765.
Amy Mangum is licensed to practice in Oregon (license number 402335) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1134766108.
Healthcare Provider's Profile
Full Name | Amy Mangum |
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Gender | Female |
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Speciality | Occupational Therapist |
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Location | 1815 Sw Marlow Ave Ste 110, Portland, Oregon |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1134766108
- Provider Enumeration Date: 12/09/2019
- Last Update Date: 09/03/2024
Medicare PECOS Information:
- PECOS PAC ID: 9830630169
- Enrollment ID: I20240926000442
Medical Identifiers
Medical identifiers for Amy Mangum such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1134766108 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
225X00000X | Occupational Therapist | 402335 (Oregon) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amy Mangum allows following entities to bill medicare on her behalf.
Entity Name | Progressive Rehabilitation Associates Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1790760908 PECOS PAC ID: 3476547258 Enrollment ID: O20040413001850 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amy Mangum is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Amy Mangum, LOTR 5424 Ne 41st Ave, Portland, OR 97211-8045 Ph: () - | Amy Mangum, LOTR 1815 Sw Marlow Ave Ste 110, Portland, OR 97225-5186 Ph: (503) 292-0765 |
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