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STOUT PERFORMANCE AND PHYSICAL THERAPY LLC
NPI 1790593739
Physical Therapist - Sports in Portland, OR

Active since December 23, 2024
710 NE HOLLADAY ST # 150, PORTLAND, OR 97232(503) 542-2744 Get Directions Write a Review

NPPES record last updated: December 23, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Stout Performance And Physical Therapy Llc NPPES

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

STOUT PERFORMANCE AND PHYSICAL THERAPY LLC (NPI 1790593739) is a healthcare organization registered as a sports in Portland, Oregon and active in the NPI registry since December 2024. The organization lists Jake Stout, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1790593739
Entity TypeOrganization
Primary Taxonomy2251S0007X
Legal Business NameSTOUT PERFORMANCE AND PHYSICAL THERAPY LLC
Location Address710 NE HOLLADAY ST # 150Portland, OR 97232-2168
Mailing Address710 Ne Holladay St # 150Portland, OR 97232-2168
Phone(503) 542-2744
Organization SubpartNo
Authorized OfficialJake StoutOwner/provider · (503) 949-1727
Enumeration DateDecember 23, 2024
NPPES CertifiedDecember 22, 2024
✔ NPI 1790593739 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · SportsRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251S0007X
Definition
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.
710 NE HOLLADAY ST # 150, 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 Moda Health Plan, Inc..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)

Stout Performance And Physical Therapy Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Stout Performance And Physical Therapy LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jacob Stout
Physical Therapist in Private Practice
NPI 1851790570
710 NE HOLLADAY ST
Portland, OR 97232
(503) 949-1727
✔ Accepts MedicareSame address

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 Stout Performance And Physical Therapy LLC's NPI number?

The NPI number for Stout Performance And Physical Therapy LLC is 1790593739. It was assigned to this organization in the NPPES registry on December 23, 2024.

Where is Stout Performance And Physical Therapy LLC located?

Stout Performance And Physical Therapy LLC is located at 710 NE Holladay St # 150, Portland, OR 97232. The listed phone number is (503) 542-2744.

What is Stout Performance And Physical Therapy LLC's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Sports, with taxonomy code 2251S0007X.

Is Stout Performance And Physical Therapy LLC enrolled in Medicare?

Yes. Stout Performance And Physical Therapy LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Stout Performance And Physical Therapy LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Physical Therapist in Private Practice) reassigns their Medicare billing to Stout Performance And Physical Therapy 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Stout Performance And Physical Therapy LLC accept?

Health plans from Moda Health Plan, Inc. list Stout Performance And Physical Therapy 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 Stout Performance And Physical Therapy LLC was last updated on December 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.