Individual provider Active NPI

Bryan Onuselogu, DPT

  • Orthopedic Physical Therapist
  • Surprise, AZ
National Provider Identifier
1154842276
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
13089 Issued in AZ
Practice address
15021 W Bell Rd Ste 125
Surprise, AZ 85374-3916
Phone
(623) 476-7880
NPI assigned
Jun 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 13089 AZ Primary

Addresses

Primary practice location

15021 W Bell Rd Ste 125
Surprise, AZ 85374-3916

Mailing address

9055 E Catalina Hwy Apt 2104
Tucson, AZ 85749-7400

Other practice location 1

7119 E Broadway Blvd
Tucson, AZ 85710-1404
Phone (520) 881-0050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230411000749 AZ Practitioner - Physical Therapist in Private Practice 0547523342 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13089AZMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Luna Care Physical Therapy, LLC Orthopedic CurrentSince Mar 1, 2023 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC CurrentSince Jul 1, 2023 Accepting new patients
Greater Phoenix Collaborative Care PC CurrentSince Sep 1, 2024 Accepting new patients
Greater Phoenix Collaborative Care PC CurrentSince Sep 1, 2024 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC Orthopedic CurrentSince Jul 1, 2023 Accepting new patients

Locations

6788 S Kings Ranch Rd
Ste 4
Gold Canyon, AZ 85118
Phone (480) 982-1909

14050 N 83rd Ave
Ste 290
Peoria, AZ 85381
Phone (623) 261-1362

9069 W Olive Ave
Ste 105
Peoria, AZ 85345
Phone (623) 257-2079

15410 S Mountain Pkwy
Ste 112
Phoenix, AZ 85044
Phone (480) 609-0822

5830 N 19th Ave
Phoenix, AZ 85015
Phone (602) 249-0115

15021 W Bell Rd
Ste 125
Surprise, AZ 85374
Phone (623) 476-7880

1460 W Valencia Rd
Tucson, AZ 85746
Phone (520) 573-0966

3305 N Swan Rd
Ste 115
Tucson, AZ 85712
Phone (520) 321-0204

Interoperability endpoints

  • Direct secure messaging: bryan.onuselogu.2@14940.direct.athenahealth.com

Organizations & group practices 5

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": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1154842276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9055 E CATALINA HWY APT 2104",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857497400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15021 W BELL RD STE 125",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853743916",
            "telephone_number": "623-476-7880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7119 E Broadway Blvd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857101404",
            "country_code": "US",
            "telephone_number": "520-881-0050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONUSELOGU",
        "first_name": "BRYAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-28",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "13089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.