Individual provider Active NPI

Cortlyn Sebastian, DPT

  • Physical Therapist
  • Raleigh, NC
National Provider Identifier
1104574144
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P20895 Issued in NC
Practice address
1300 Corporation Pkwy Ste B
Raleigh, NC 27610-1362
Phone
(919) 917-7729
Fax
(919) 400-4178
NPI assigned
Mar 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 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 P20895 NC Primary

Addresses

Primary practice location

1300 Corporation Pkwy Ste B
Raleigh, NC 27610-1362

Mailing address

1300 Corporation Pkwy Ste B
Raleigh, NC 27610-1362
Phone (919) 917-7729

Other names 1

  • Cortlyn Van Deutsch Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250416000570 NC Practitioner - Physical Therapist in Private Practice 2466977137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revive Boost Rebuild Physical Therapy LLCGroup PAC ID 5597063602, 2 clinicians

Practice addresses (Care Compare)

1300 Corporation Pkwy
Suite B
Raleigh, NC 27610-1362
Phone 91991777291002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P20895NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Revive Boost Rebuild Physical Therapy LLC Physical Therapist CurrentSince Feb 7, 2025 Accepting new patients

Locations

106 Farm Brook Dr
Ste C
Lumberton, NC 28358
Phone (919) 727-9373

1300 Corporation Pkwy
Ste B
Raleigh, NC 27610
Phone (919) 917-7729

Organizations & group practices 1

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": "1647475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1104574144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 CORPORATION PKWY STE B",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101362",
            "telephone_number": "919-917-7729",
            "fax_number": "919-400-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 CORPORATION PKWY STE B",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101362",
            "telephone_number": "919-917-7729",
            "fax_number": "919-400-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBASTIAN",
        "first_name": "CORTLYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-17",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P20895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORTLYN",
            "last_name": "VAN DEUTSCH",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.