Individual provider Active NPI

Austin Sitterly, DPT

  • Physical Therapist
  • Laveen, AZ
National Provider Identifier
1417528050
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
31814 Issued in AZ
Practice address
5215 W Baseline Rd Ste 101
Laveen, AZ 85339-2943
Phone
(623) 219-4600
Fax
(623) 219-4601
NPI assigned
Jul 6, 2021
Last updated
Mar 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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 31814 AZ Primary

Addresses

Primary practice location

5215 W Baseline Rd Ste 101
Laveen, AZ 85339-2943

Mailing address

14287 N 87TH St Ste 220
Scottsdale, AZ 85260-3698
Phone (602) 329-8250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31814AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spooner Physical Therapy & Hand Rehab, PC Physical Therapist Past Accepting new patients

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, 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": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1417528050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14287 N 87TH ST STE 220",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603698",
            "telephone_number": "602-329-8250",
            "fax_number": "480-565-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 W BASELINE RD STE 101",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853392943",
            "telephone_number": "623-219-4600",
            "fax_number": "623-219-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SITTERLY",
        "first_name": "AUSTIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-06",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "31814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laveen, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.