Holistic Community Therapy Llc is a medicare enrolled "Community/behavioral Health" provider in Portland, Oregon. Their current practice location is
4339 Ne 115th Ave, Portland, Oregon. You can reach out to their office (for appointments etc.) via phone at
(720) 297-4572.
Holistic Community Therapy Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Holistic Community Therapy Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1073179776.
Healthcare Provider's Profile
| Full Name | Holistic Community Therapy Llc |
|---|
| Type | Facility |
|---|
| Speciality | Community/behavioral Health |
|---|
| Location | 4339 Ne 115th Ave, Portland, Oregon |
|---|
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1073179776
- Provider Enumeration Date: 05/17/2019
- Last Update Date: 08/09/2020
Medicare PECOS Information:
- PECOS PAC ID: 0547692618
- Enrollment ID: O20191111001442
Medical Identifiers
Medical identifiers for Holistic Community Therapy Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1073179776 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225XN1300X | Occupational Therapist - Neurorehabilitation | (* (Not Available)) | Secondary |
| 251E00000X | Home Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Holistic Community Therapy Llc acts as a billing entity for following providers:
| Provider Name | Julie K Allen |
|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
|---|
| Provider Identifiers | NPI Number: 1477657567
PECOS PAC ID: 5092797456
Enrollment ID: I20080111000265 |
|---|
| Provider Name | Elizabeth M Martin |
|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
|---|
| Provider Identifiers | NPI Number: 1790225712
PECOS PAC ID: 1456783521
Enrollment ID: I20191111001790 |
|---|
| Provider Name | Kiley Kathleen Petencin |
|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
|---|
| Provider Identifiers | NPI Number: 1639810823
PECOS PAC ID: 3971968769
Enrollment ID: I20230501001390 |
|---|
| Provider Name | Tiffany Tienyih Tung |
|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
|---|
| Provider Identifiers | NPI Number: 1659085173
PECOS PAC ID: 1052773611
Enrollment ID: I20230814001954 |
|---|
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. Holistic Community Therapy Llc 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 |
|---|
Holistic Community Therapy Llc
4339 Ne 115th Ave,
Portland, OR 97220-1409
Ph: (503) 882-0988 | Holistic Community Therapy Llc
4339 Ne 115th Ave,
Portland, OR 97220-1409
Ph: (720) 297-4572 |
Reviews and Comments