Individual provider Active NPI

Sean Liam Danagher

  • Physical Therapist
  • San Carlos, CA
National Provider Identifier
1164532826
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
125 Shoreway Rd
Ste. 1500
San Carlos, CA 94070-2788
Phone
(650) 591-9581
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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 Primary

Addresses

Primary practice location

125 Shoreway Rd
Ste. 1500
San Carlos, CA 94070-2788

Mailing address

654 Beacon St
Ste 2
Boston, MA 02215-2099
Phone (617) 536-1161

Other identifiers 1

IdentifierTypeStateIssuer
21738OtherCALICENSE #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240205003903 CA Practitioner - Physical Therapist in Private Practice 7416205018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Jan 4, 2024 Accepting new patients
Select Physical Therapy Holdings Inc Past Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1164532826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 BEACON ST",
            "address_2": "STE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022152099",
            "telephone_number": "617-536-1161",
            "fax_number": "617-536-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SHOREWAY RD",
            "address_2": "STE. 1500",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702788",
            "telephone_number": "650-591-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANAGHER",
        "first_name": "SEAN",
        "middle_name": "LIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "21738",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.