Individual provider Active NPI

Rebeca Luisa Segraves, PT, DPT

  • Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1154703460
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0017364 Issued in CO
Practice address
6364 Marilee Way
Colorado Springs, CO 80911-8356
Phone
(719) 270-0155
Fax
(719) 349-5267
NPI assigned
Jun 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-2024-0030 NM
Physical Therapist 225100000X 1325234 TX
Physical Therapist 225100000X 0017364 CO Primary

Addresses

Primary practice location

6364 Marilee Way
Colorado Springs, CO 80911-8356

Mailing address

6364 Marilee Way
Colorado Springs, CO 80911-8356
Phone (719) 270-0155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TX, CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210816001867 CO Practitioner - Physical Therapist in Private Practice 3476869165 Reassigns benefits to 1 organization
I20250719000267 TX Practitioner - Physical Therapist in Private Practice 3476869165 Reassigns benefits to 1 organization
I20251022001478 CA Practitioner - Physical Therapist in Private Practice 3476869165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Origin Physical Therapy FL PLLCGroup PAC ID 1759813348, 77 clinicians

Practice addresses (Care Compare)

12411 Hymeadow Dr
Austin, TX 78750-1874
Phone (213) 898-2673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0017364COMDMental Health Counselor
PT-2024-0030NMMDPhysical Therapist
1325234TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Covell Care and Rehabilitation, LLC Physical Therapist CurrentSince Oct 30, 2025 Accepting new patients
Origin Physical Therapy Ca Inc Physical Therapist CurrentSince Jul 24, 2025 Accepting new patients
Origin Physical Therapy FL PLLC Physical Therapist CurrentSince Jun 25, 2025 Accepting new patients
Sullivan Physical Therapy LLC Physical Therapist PastSince Mar 16, 2023 Accepting new patients

Locations

7188 Avenida Encinas
Ste 110
Carlsbad, CA 92011

11980 San Vicente Blvd
Ste 100
Los Angeles, CA 90049
Phone (310) 479-2323

12411 Hymeadow Dr
Ste 3B
Austin, TX 78750
Phone (512) 250-8497

2712 Bee Caves Rd
Ste 122A
Austin, TX 78746
Phone (737) 234-9618

4950 Terminal St
Ste 100
Bellaire, TX 77401
Phone (832) 307-0894

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1154703460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6364 MARILEE WAY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809118356",
            "telephone_number": "719-270-0155",
            "fax_number": "719-349-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6364 MARILEE WAY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809118356",
            "telephone_number": "719-270-0155",
            "fax_number": "719-349-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGRAVES",
        "first_name": "REBECA",
        "middle_name": "LUISA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "PT-2024-0030",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1325234",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0017364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.