Individual provider Active NPI

Paul Sevilla, PT, DPT

  • Physical Therapist
  • West Bloomfield, MI
National Provider Identifier
1114620408
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501302571 Issued in MI
Practice address
33340 W 14 Mile Rd
West Bloomfield, MI 48322-3572
Phone
(248) 538-7607
Fax
(248) 538-7623
NPI assigned
Mar 24, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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 5501302571 MI Primary

Addresses

Primary practice location

33340 W 14 Mile Rd
West Bloomfield, MI 48322-3572

Mailing address

33340 W 14 Mile Rd
West Bloomfield, MI 48322-3572
Phone (248) 538-7607

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dearborn Physical Therapy LTD. Physical Therapist CurrentSince Oct 21, 2025 Accepting new patients
Dearborn Physical Therapy LTD. PastSince Oct 5, 2025 Accepting new patients
Renue 018 Tawas, LLC Physical Therapist PastSince Aug 25, 2021 Accepting new patients
Mymichigan Medical Center Midland PastSince Mar 27, 2023 Accepting new patients

Locations

33340 W 14 Mile Rd
West Bloomfield, MI 48322
Phone (248) 538-7607

Organizations & group practices 4

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": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1114620408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33340 W 14 MILE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223572",
            "telephone_number": "248-538-7607",
            "fax_number": "248-538-7623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33340 W 14 MILE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223572",
            "telephone_number": "248-538-7607",
            "fax_number": "248-538-7623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVILLA",
        "first_name": "PAUL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-24",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501302571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.