Individual provider Active NPI

Alexander R Sebben, PT

  • Physical Therapist
  • Lehigh Acres, FL
National Provider Identifier
1457592636
Registry record updated Oct 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT20164 Issued in FL
Practice address
4316 Lee Blvd
#12B
Lehigh Acres, FL 33971-1735
Phone
(239) 368-7744
Fax
(239) 368-7814
NPI assigned
Mar 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2014

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 PT20164 FL Primary

Addresses

Primary practice location

4316 Lee Blvd
#12B
Lehigh Acres, FL 33971-1735

Mailing address

2328 Hancock Bridge Pkwy
Suite 103
Cape Coral, FL 33990-1459
Phone (239) 573-1518

Other identifiers 1

IdentifierTypeStateIssuer
686520OtherFLMEDICARE GROUP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090522000404 FL Practitioner - Physical Therapist in Private Practice 8426107376

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT20164FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Back in Motion Sport & Spine Physical Therapy LLC Physical Therapist CurrentSince Feb 5, 2024 Accepting new patients
Bonita Springs Sports & Physical Therapy Center Inc Physical Therapist PastSince Oct 6, 2010 Accepting new patients
Neuroscience and Spine Associates PL Past Accepting new patients
Orthopedic Center of Florida, Inc Past Accepting new patients
Bayonne Physical Therapy Inc Physical Therapist Past Accepting new patients

Locations

4784 Pelican Sound Blvd
Estero, FL 33928
Phone (239) 233-0484

9400 Gladiolus Dr
Ste 100
Fort Myers, FL 33908
Phone (239) 223-0484

9724 Commerce Center Ct
Ste B
Fort Myers, FL 33908
Phone (239) 223-0484

Organizations & group practices 5

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": "1237248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1457592636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 HANCOCK BRIDGE PKWY",
            "address_2": "SUITE 103",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339901459",
            "telephone_number": "239-573-1518",
            "fax_number": "239-573-7356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4316 LEE BLVD",
            "address_2": "#12B",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339711735",
            "telephone_number": "239-368-7744",
            "fax_number": "239-368-7814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBBEN",
        "first_name": "ALEXANDER",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-17",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT20164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "686520",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.