MICHELE SHIVACK PT, ATC NPI 1184962128
Physical Therapist - Orthopedic in Portland, OR
About MICHELE SHIVACK PT,ATC
Michele Shivack is a provider established in Portland, Oregon and her medical specialization is Physical Therapist with a focus in orthopedic . The NPI number of Michele Shivack is 1184962128 and was assigned on January 2013. The practitioner's primary taxonomy code is 2251X0800X with license number 04108 (OR). The provider is registered as an individual and her NPI record was last updated 9 years ago.
| NPI | 1184962128 |
| Provider Name | MICHELE SHIVACK PT,ATC |
| Provider Location Address | 11782 SW BARNES RD SUITE 300 PORTLAND, OR 97225 |
| Provider Mailing Address | 11782 SW BARNES RD SUITE 300 PORTLAND, OR 97225 |
| Gender | Female |
| NPI Entity Type | Individual |
| Is Sole Proprietor? | No |
| Enumeration Date | 01-25-2013 |
| Last Update Date | 09-13-2013 |
Michele Shivack is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.
Primary Taxonomy
| Taxonomy Code | 2251X0800X |
| Classification | Physical Therapist |
| Type | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Specialization | Orthopedic |
| License No. | 04108 |
| License State | OR |
| Taxonomy Description | A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice. |
Business Address
MICHELE SHIVACK PT,ATC
11782 SW BARNES RD
SUITE 300
PORTLAND, OR
ZIP 97225
Phone: (503) 906-4323
Fax: (503) 906-4333
Mailing Address
MICHELE SHIVACK PT,ATC
11782 SW BARNES RD
SUITE 300
PORTLAND, OR
ZIP 97225
Phone: (503) 906-4323
Fax: (503) 906-4333
Secondary Taxonomies
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 2251S0007X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports | 4108 | OR | No |
Taxonomy Description: a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, pathology and pathophysiology, medical and surgical intervention, and health and wellness, as well as rehabilitation/return to sports, management of acute injury/illness, medical and surgical consideration, injury prevention, and sports performance enhancement. | |||||||
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 04108 | OTHER (01) | OR | LICENSE NUMBER |
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 8 | 4 | 9 | 6 | 2 | 1 | 2 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 16 | 4 | 18 | 6 | 4 | 1 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 6 + 4 + 1 + 8 + 6 + 4 + 1 + 4 + 24 = 62 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 62 = 8 | 8 | ||||||||
The NPI number 1184962128 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the same location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1184693020 | MR. MICHAEL D MONETA MD Individual | Anesthesiology | 11782 SW BARNES RD BLDG C #200 PORTLAND, OR 97225 (503) 906-4300 |
| 1295704443 | MR. DALE L NUNEZ MD Individual | Anesthesiology | 11782 SW BARNES RD BLDG C #200 PORTLAND, OR 97225 (503) 906-4300 |
| 1356300925 | MICHAEL D MONETA MD PC Organization | Anesthesiology | 11782 SW BARNES RD BLDG C #200 PORTLAND, OR 97225 (503) 906-4300 |
| 1770543308 | DALE L NUNEZ MD PC Organization | Anesthesiology | 11782 SW BARNES RD BLDG C #200 PORTLAND, OR 97225 (503) 906-4300 |
| 1326002601 | THELMA J MAYS MD Individual | Anesthesiology | 11782 SW BARNES RD BLDG C 200 PORTLAND, OR 97225 (503) 906-4300 |
| 1285699074 | KATRINA KELLAR ATC, OTC Individual | Technician, Other | 11782 SW BARNES RD PORTLAND, OR 97225 (503) 214-5200 |
| 1174580435 | THELMA JEAN MAYS MD PC Organization | Anesthesiology | 11782 SW BARNES RD BLDG C 200 PORTLAND, OR 97225 (503) 906-4300 |
| 1093737934 | DR. ILMAR SOOT M.D. Individual | Specialist | 11782 SW BARNES RD STE 300 PORTLAND, OR 97225 (503) 214-5200 |
| 1336153352 | ROBERT L BURKHART P.A. Individual | Physician Assistant (Surgical) | 11782 SW BARNES RD STE 300 PORTLAND, OR 97225 (503) 214-5200 |
| 1609887413 | CSS JV, LLC Organization | Clinic/Center (Ambulatory Surgical) | 11782 SW BARNES RD #200 PORTLAND, OR 97225 (503) 906-4300 |
| 1376640631 | MS. REBECCA CHANGIZIAN CST SAC Individual | 11782 SW BARNES RD SUITE 200 PORTLAND, OR 97225 (503) 906-4300 | |
| 1821370875 | LIMELIGHT GROUP Organization | Anesthesiology | 11782 SW BARNES RD BUILDING C SUITE 200 PORTLAND, OR 97225 (503) 906-4300 |
| 1235485053 | NICK ADAM GEORGE MPT Individual | Physical Therapist (Orthopedic) | 11782 SW BARNES RD STE 100 PORTLAND, OR 97225 (503) 906-4323 |
| 1366799405 | JESSICA LYNN MARTSCHINSKE MA, ATC/L, OTC Individual | Specialist/Technologist (Athletic Trainer) | 11782 SW BARNES RD SUITE 300 PORTLAND, OR 97225 (503) 214-5200 |
| 1801043591 | RONALD C SMITH PA-C, MMSC Individual | Physician Assistant (Surgical) | 11782 SW BARNES RD SUITE 300 PORTLAND, OR 97225 (503) 214-5200 |
| 1063738755 | MS. SANDI JO MCRAE OT Individual | Occupational Therapist | 11782 SW BARNES RD STE 300 PORTLAND, OR 97225 (503) 214-5200 |
| 1790774537 | MRS. SUSAN LEE WATKINS FNP Individual | Nurse Practitioner (Family) | 11782 SW BARNES RD SUITE 300 PORTLAND, OR 97225 (503) 214-5200 |
| 1922116623 | ROSALYN MARIE MONTGOMERY M.D. Individual | Orthopaedic Surgery | 11782 SW BARNES RD SUITE 300 PORTLAND, OR 97225 (503) 214-5200 |
| 1073059754 | DANIEL LEWIS FISHER CST Individual | Specialist/Technologist, Other (Surgical Technologist) | 11782 SW BARNES RD SUITE 300 PORTLAND, OR 97225 (503) 214-5200 |
| 1902344187 | CORVIN W TOMPKINS SA-C Individual | Specialist/Technologist, Other (Surgical Assistant) | 11782 SW BARNES RD SUITE 200 PORTLAND, OR 97225 (503) 906-4300 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
Michele Shivack Pt,atc is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:
- 1 = Person: individual human being who furnishes health care.
- 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.