Individual provider Active NPI

Sean Simon

  • Physical Therapist
  • Willow Grove, PA
National Provider Identifier
1457199119
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2325 Maryland Rd
Willow Grove, PA 19090-1749
Phone
(215) 659-7759
Fax
(215) 659-6658
NPI assigned
Jul 17, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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 Primary

Addresses

Primary practice location

2325 Maryland Rd
Willow Grove, PA 19090-1749

Mailing address

607 Thornhill Dr
Lafayette Hill, PA 19444-1615
Phone (347) 405-3422

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240923001144 PA Practitioner - Physical Therapist in Private Practice 5799226320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willow Grove Physical Therapy LLCGroup PAC ID 0749189256, 22 clinicians

Practice addresses (Care Compare)

2325 Maryland Rd
Suite 205
Willow Grove, PA 19090-1760
Phone (215) 659-7759

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Grove Physical Therapy, LLC Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients
Naspac-NJ PLLC PastSince Jul 21, 2024 Accepting new patients

Locations

55 N York Rd
Ste 100
Hatboro, PA 19040
Phone (215) 394-5116

2325 Maryland Rd
Ste 205
Willow Grove, PA 19090
Phone (215) 586-3772

Organizations & group practices 2

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": "1721174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1457199119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 THORNHILL DR",
            "city": "LAFAYETTE HILL",
            "state": "PA",
            "postal_code": "194441615",
            "telephone_number": "347-405-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 MARYLAND RD",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901749",
            "telephone_number": "215-659-7759",
            "fax_number": "215-659-6658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "SEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Grove, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.