Individual provider Active NPI

Raffy Yu Seares, PT, DPT

  • Physical Therapist
  • Texarkana, TX
National Provider Identifier
1194226100
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1233058 Issued in TX
Practice address
3494A Summerhill Rd
Texarkana, TX 75503-3560
Phone
(870) 571-4002
Fax
(903) 306-2570
NPI assigned
Feb 24, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT3820 AR
Physical Therapist 225100000X 1233058 TX Primary

Addresses

Primary practice location

3494A Summerhill Rd
Texarkana, TX 75503-3560

Mailing address

3494A Summerhill Rd
Texarkana, TX 75503-3560
Phone (870) 571-4002

Other identifiers 1

IdentifierTypeStateIssuer
401274201MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190826000515 TX Practitioner - Physical Therapist in Private Practice 1759619075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14 Red Oak LN
Texarkana, TX 75503-9344
Phone (870) 571-4002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT3820ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Physical Therapy and Rehabilitation, LLC Physical Therapist CurrentSince Apr 24, 2019 Accepting new patients

Locations

3494A Summerhill Rd
Texarkana, TX 75503
Phone (870) 571-4002

Organizations & group practices 1

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": "1519430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1194226100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3494A SUMMERHILL RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033560",
            "telephone_number": "870-571-4002",
            "fax_number": "903-306-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3494A SUMMERHILL RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033560",
            "telephone_number": "870-571-4002",
            "fax_number": "903-306-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEARES",
        "first_name": "RAFFY",
        "middle_name": "YU",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-24",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT3820",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1233058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401274201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.