Individual provider Active NPI

David Amsellem, PT

  • Physical Therapist
  • Scottsdale, AZ
National Provider Identifier
1104064633
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2772 Issued in AZ
Practice address
12169 E Cortez Dr
Scottsdale, AZ 85259-3324
Phone
(480) 216-3938
Fax
(480) 659-9898
NPI assigned
Jan 21, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

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 2772 AZ Primary

Addresses

Primary practice location

12169 E Cortez Dr
Scottsdale, AZ 85259-3324

Mailing address

12169 E Cortez Dr
Scottsdale, AZ 85259-3324
Phone (480) 216-3938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2772AZMDPhysical Therapist
2742AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Well Street Physical Therapist PastSince Feb 5, 2009 Accepting new patients
Focus Home Therapy & Medical Services, LLC Past Accepting new patients

Organizations & group practices 2

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": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1104064633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12169 E CORTEZ DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852593324",
            "telephone_number": "480-216-3938",
            "fax_number": "480-659-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12169 E CORTEZ DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852593324",
            "telephone_number": "480-216-3938",
            "fax_number": "480-659-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMSELLEM",
        "first_name": "DAVID",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-21",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "2772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.