Individual provider Active NPI

Sheena Marie Sagrado Caramba, DPT

  • Physical Therapist
  • Lynnwood, WA
National Provider Identifier
1306690060
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3105 Alderwood Mall Blvd Ste H
Lynnwood, WA 98036-4703
Phone
(425) 582-5902
Fax
(425) 412-2980
NPI assigned
Apr 17, 2024
Last updated
May 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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 1335152 TX
Physical Therapist 225100000X WA Primary

Addresses

Primary practice location

3105 Alderwood Mall Blvd Ste H
Lynnwood, WA 98036-4703

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

18839 McKay Dr
Humble, TX 77338-5721
Phone (281) 446-3655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240522003390 WA Practitioner - Physical Therapist in Private Practice 7012359052 Reassigns benefits to 1 organization
I20260612003755 TX Practitioner - Physical Therapist in Private Practice 7012359052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2600 N Loop W
Suite 120
Houston, TX 77092-8917
Phone (713) 650-6900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1335152TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Physical Therapy LLC Physical Therapist CurrentSince May 14, 2024 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist CurrentSince May 14, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

3105 Alderwood Mall Blvd
Ste H
Lynnwood, WA 98036
Phone (425) 582-5902

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1306690060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 ALDERWOOD MALL BLVD STE H",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364703",
            "telephone_number": "425-582-5902",
            "fax_number": "425-412-2980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18839 McKay Dr",
            "address_purpose": "LOCATION",
            "city": "Humble",
            "state": "TX",
            "postal_code": "773385721",
            "country_code": "US",
            "telephone_number": "281-446-3655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARAMBA",
        "first_name": "SHEENA MARIE",
        "middle_name": "SAGRADO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1335152",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.