Individual provider Active NPI

William Daniel Siesel, PT

  • Specialist
  • Saint Petersburg, FL
National Provider Identifier
1124404918
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT30370 Issued in FL
Practice address
419 Pasadena Ave S
Saint Petersburg, FL 33707-2101
Phone
(727) 384-4600
Fax
(727) 384-4601
NPI assigned
Aug 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT30370 FL Primary

Addresses

Primary practice location

419 Pasadena Ave S
Saint Petersburg, FL 33707-2101

Mailing address

419 Pasadena Ave S
Saint Petersburg, FL 33707-2101
Phone (727) 384-4600

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT30370FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Physical Therapy and Wellness Inc Past Accepting new patients
Seabreeze Physical Therapy, Inc. Specialist PastSince Dec 14, 2011 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": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1124404918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 PASADENA AVE S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337072101",
            "telephone_number": "727-384-4600",
            "fax_number": "727-384-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 PASADENA AVE S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337072101",
            "telephone_number": "727-384-4600",
            "fax_number": "727-384-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIESEL",
        "first_name": "WILLIAM",
        "middle_name": "DANIEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "PT30370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; 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.