Active NPI
Serge B Saithsoothane, P.T.
- Physical Therapist
- Plano, TX
National Provider Identifier
1295866002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1055903
- Practice address
- 2301 Coit Rd Ste B
Plano, TX 75075 - Phone
- (972) 599-9191
- Fax
- (972) 599-2323
- NPI assigned
- Mar 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1055903 | TX | Primary |
Addresses
Primary practice location
2301 Coit Rd Ste B
Plano, TX 75075
Mailing address
PO Box 415
San Antonio, TX 78292
Phone (972) 599-9191
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295866002 | Other | TX | INDIVIDUAL NPI NUMBER |
| 8T0895 | Other | TX | BCBS OF TEXAS PROVIDER # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120324000039 | TX | Practitioner - Physical Therapist in Private Practice | 5799945036 | Practice locations: Plano, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231459200000",
"number": "1295866002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 415",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78292",
"telephone_number": "972-599-9191",
"fax_number": "972-599-2323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 COIT RD STE B",
"city": "PLANO",
"state": "TX",
"postal_code": "75075",
"telephone_number": "972-599-9191",
"fax_number": "972-599-2323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAITHSOOTHANE",
"first_name": "SERGE",
"middle_name": "B",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-07",
"last_updated": "2009-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1055903",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIVIDUAL NPI NUMBER",
"identifier": "1295866002",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TEXAS PROVIDER #",
"identifier": "8T0895",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2009; 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.