Individual provider Active NPI

Eduardo M Sia III, DPT

  • Physical Therapist
  • Northglenn, CO
National Provider Identifier
1043096845
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01944000 Issued in NJ
Practice address
420 E 120TH Ave
Northglenn, CO 80233-1127
Phone
(303) 280-3838
NPI assigned
Sep 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP029811T CO
Physical Therapist 225100000X 40QA01944000 NJ Primary

Addresses

Primary practice location

420 E 120TH Ave
Northglenn, CO 80233-1127

Mailing address

100 High St
Eatontown, NJ 07724-3424
Phone (732) 766-2107

Other practice location 1

100 High St
Eatontown, NJ 07724-3424
Phone (732) 766-2107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231219003183 AZ Practitioner - Physical Therapist in Private Practice 6002266988 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP029811TCOMDPhysical Therapist
40QA01944000NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
BHSM Rehabilitation, LLC CurrentSince Oct 16, 2023 Accepting new patients
BHSM Rehabilitation, LLC CurrentSince Oct 16, 2023 Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients

Locations

3507 S Mercy Rd
Ste A
Gilbert, AZ 85297
Phone (480) 926-0404

2120 Airway Ave
Kingman, AZ 86409
Phone (928) 757-1211

17430 N Porter Rd
Ste 110
Maricopa, AZ 85138
Phone (520) 208-2033

5002 S Mill Ave
Ste 105
Tempe, AZ 85282
Phone (602) 512-8607

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1043096845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077243424",
            "telephone_number": "732-766-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 120TH AVE",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802331127",
            "telephone_number": "303-280-3838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 High St",
            "address_purpose": "LOCATION",
            "city": "Eatontown",
            "state": "NJ",
            "postal_code": "077243424",
            "country_code": "US",
            "telephone_number": "732-766-2107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIA",
        "first_name": "EDUARDO",
        "middle_name": "M",
        "name_suffix": "III",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-06",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "CP029811T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01944000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northglenn, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.