Individual provider Active NPI

Regina Siciliano, DPT

  • Physical Therapist
  • San Rafael, CA
National Provider Identifier
1073096061
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
309028 Issued in CA
Practice address
1099 D St Ste 105
San Rafael, CA 94901-2839
Phone
(415) 532-8335
NPI assigned
Sep 14, 2018
Last updated
Aug 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 309028 CA Primary

Addresses

Primary practice location

1099 D St Ste 105
San Rafael, CA 94901-2839

Mailing address

1099 D St Ste 105
San Rafael, CA 94901-2839
Phone (415) 532-8335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240103004416 AZ Practitioner - Physical Therapist in Private Practice 7618212028 Reassigns benefits to 1 organization
I20260327003920 CA Practitioner - Physical Therapist in Private Practice 7618212028 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Select Cal Physical Therapy PCGroup PAC ID 4789070699, 162 clinicians
Sand Coast Rehab Physical Therapy IncGroup PAC ID 7315352911, 131 clinicians

Practice addresses (Care Compare)

1099 D St
San Rafael, CA 94901-2829
Phone (415) 532-8335

501 Via Casitas
Greenbrae, CA 94904-1901
Phone (732) 994-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
309028CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
BHSM Rehabilitation LLC CurrentSince Dec 1, 2023 Accepting new patients
BHSM Rehabilitation, LLC CurrentSince Dec 1, 2023 Accepting new patients
BHSM Rehabilitation, LLC Current Accepting new patients
BHSM Rehabilitation, LLC Past Accepting new patients
BHSM Rehabilitation, LLC Past Accepting new patients

Locations (25 of 44)

10750 W McDowell Rd
Ste B210
Avondale, AZ 85392
Phone (623) 907-0746

13055 W McDowell Rd
Ste G107
Avondale, AZ 85392
Phone (623) 547-4787

1828 E Florence Blvd
Ste 102
Casa Grande, AZ 85122
Phone (520) 381-6300

2055 W Frye Rd
Ste 2
Chandler, AZ 85224
Phone (480) 821-9840

4015 S Arizona Ave
Ste C2
Chandler, AZ 85248
Phone (480) 426-8019

655 S Dobson Rd
Ste B111
Chandler, AZ 85224
Phone (480) 426-8019

2940 E Banner Gateway Dr
Ste 425
Gilbert, AZ 85234
Phone (480) 543-2000

3507 S Mercy Rd
Bldg 8
Gilbert, AZ 85297

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

4344 W Bell Rd
Ste 100
Glendale, AZ 85308
Phone (602) 277-0084

6320 W Union Hills Dr
Ste 265
Glendale, AZ 85308
Phone (602) 373-6724

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

10165 E Hampton Ave
Ste 111
Mesa, AZ 85209
Phone (480) 354-5424

1255 W Baseline Rd
Ste 140
Mesa, AZ 85202
Phone (480) 820-7675

2225 W Southern Ave
Bldg 1300
Mesa, AZ 85202
Phone (480) 330-0456

2853 S Sossaman Rd
Ste A106
Mesa, AZ 85212
Phone (480) 326-3922

5151 E Broadway Rd
Ste 102
Mesa, AZ 85206
Phone (480) 396-9922

126 E Main St
Ste C
Payson, AZ 85541
Phone (928) 468-8907

25101 N Lake Pleasant Pkwy
Ste B1340
Peoria, AZ 85383
Phone (602) 610-6866

9401 W Thunderbird Rd
Ste 190
Peoria, AZ 85381
Phone (623) 977-5451

14001 N 7th St
Ste A102
Phoenix, AZ 85022
Phone (602) 548-5445

1661 E Camelback Rd
Ste 152
Phoenix, AZ 85016
Phone (602) 955-8885

20045 N 19th Ave
Bldg 8
Phoenix, AZ 85027
Phone (623) 374-2424

219 E Lexington Ave
Phoenix, AZ 85012
Phone (602) 264-0694

2400 W Dunlap Ave
Ste 145
Phoenix, AZ 85021
Phone (602) 870-1414

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1073096061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 D ST STE 105",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012839",
            "telephone_number": "415-532-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 D ST STE 105",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012839",
            "telephone_number": "415-532-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICILIANO",
        "first_name": "REGINA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "309028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.