NPIMap

Organization Active NPI

Sese Sports Performance Group, PS

Doing business as Northwest Sports Performance & Wellness

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1285924787
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SESE SPORTS PERFORMANCE GROUP, PS
Doing business as
Northwest Sports Performance & Wellness
Practice address
1603 116TH Ave NE
111
Bellevue, WA 98004-3009
Phone
(425) 221-7253
Fax
(888) 812-4162
NPI assigned
Apr 18, 2011
Last updated
Sep 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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

Authorized official

Name
Dr. Harry Gabriel Sese, D.C.NPI 1073790317
Title
President
Phone
(425) 221-7253

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary
Athletic Trainer 2255A2300X NU
Massage Therapist 225700000X NU

Addresses

Primary practice location

1603 116TH Ave NE
111
Bellevue, WA 98004-3009

Mailing address

10351 NE 10TH St Apt 907
Bellevue, WA 98004-4645
Phone (425) 221-7253

Other names 1

  • NORTHWEST SPORTS PERFORMANCE & WELLNESS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110920000426 WA Part B Supplier - Clinic/Group Practice 7618148818 Receives reassigned benefits from 4 practitioners
Practice locations: Redmond, WA

National Provider Directory

National Provider Directory

Locations

14603 NE 87th St
Redmond, WA 98052
Phone (425) 221-7253

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316563200000",
    "number": "1285924787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10351 NE 10TH ST APT 907",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044645",
            "telephone_number": "425-221-7253",
            "fax_number": "888-812-4162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 116TH AVE NE",
            "address_2": "111",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043009",
            "telephone_number": "425-221-7253",
            "fax_number": "888-812-4162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SESE SPORTS PERFORMANCE GROUP, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-18",
        "last_updated": "2011-09-21",
        "status": "A",
        "authorized_official_last_name": "SESE",
        "authorized_official_first_name": "HARRY",
        "authorized_official_middle_name": "GABRIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-221-7253",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHWEST SPORTS PERFORMANCE & WELLNESS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.