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BROADWAY PHYSICAL THERAPY & SPORTS REHAB LLC
NPI 1326185950
Specialist in Portland, OR

Active since January 31, 2007
3016 NE BROADWAY ST, PORTLAND, OR 97232(503) 287-6636(503) 287-4044 Get Directions Write a Review

NPPES record last updated: February 13, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Broadway Physical Therapy & Sports Rehab Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROADWAY PHYSICAL THERAPY & SPORTS REHAB LLC (NPI 1326185950) is a healthcare organization registered as a specialist in Portland, Oregon and active in the NPI registry since January 2007. The organization lists Ellen R Grover, Owner, as its authorized official.

NPPES Registry Identity

NPI1326185950
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameBROADWAY PHYSICAL THERAPY & SPORTS REHAB LLC
Location Address3016 NE BROADWAY STPortland, OR 97232-1811
Mailing Address3016 Ne Broadway StPortland, OR 97232-1811 · (503) 287-6636 · Fax (503) 287-4044
Phone(503) 287-6636
Fax(503) 287-4044
Organization SubpartNo
Authorized OfficialEllen R GroverOwner · (503) 287-6636
Enumeration DateJanuary 31, 2007
Last NPPES UpdateFebruary 13, 2026
NPPES CertifiedFebruary 13, 2026
✔ NPI 1326185950 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in OR · 2270
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
3016 NE BROADWAY ST, Portland, OR 97232
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Broadway Physical Therapy & Sports Rehab Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Broadway Physical Therapy & Sports Rehab LLC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 6 within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Anne Bower, P.T.
Physical Therapist in Private Practice
NPI 1780726133
3016 NE BROADWAY ST
Portland, OR 97232
(503) 287-6636
✔ Accepts MedicareSame address
Ellen Grover, PT
Physical Therapist in Private Practice
NPI 1578546040
3016 NE BROADWAY ST
Portland, OR 97232
(503) 287-6636
✔ Accepts MedicareSame address
Stephanie Kim
Physical Therapist in Private Practice
NPI 1659889616
3016 NE BROADWAY ST
Portland, OR 97232
(503) 287-6636
✔ Accepts MedicareSame address
Kaylan Stayton, PT, DPT
Physical Therapist in Private Practice
NPI 1629837638
3016 NE BROADWAY ST
Portland, OR 97232
(503) 287-6636
✔ Accepts MedicareSame address
Ryan Cook, PT, DPT
Physical Therapist in Private Practice
NPI 1164888715
3016 NE BROADWAY ST
Portland, OR 97232
(503) 287-6636
✔ Accepts MedicareSame address
Kimberly Karlsgodt, D.P.T.
Physical Therapist in Private Practice
NPI 1770731150
914 NW 13TH AVE
Portland, OR 97209
(971) 244-9000
✔ Accepts Medicare2.4 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Broadway Physical Therapy & Sports Rehab LLC's NPI number?

The NPI number for Broadway Physical Therapy & Sports Rehab LLC is 1326185950. It was assigned to this organization in the NPPES registry on January 31, 2007.

Where is Broadway Physical Therapy & Sports Rehab LLC located?

Broadway Physical Therapy & Sports Rehab LLC is located at 3016 NE Broadway St, Portland, OR 97232. The listed phone number is (503) 287-6636.

What is Broadway Physical Therapy & Sports Rehab LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Broadway Physical Therapy & Sports Rehab LLC enrolled in Medicare?

Yes. Broadway Physical Therapy & Sports Rehab LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Broadway Physical Therapy & Sports Rehab LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians, all in Physical Therapist in Private Practice, reassign their Medicare billing to Broadway Physical Therapy & Sports Rehab LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 5 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Broadway Physical Therapy & Sports Rehab LLC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Broadway Physical Therapy & Sports Rehab LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Broadway Physical Therapy & Sports Rehab LLC was last updated on February 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.