Individual provider Active NPI

Sydney Gundersen, DPT

  • Physical Therapist
  • West Lawn, PA
National Provider Identifier
1467181313
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
307454 Issued in CA
Practice address
2211 Quarry Dr Ste E55
West Lawn, PA 19609-1161
Phone
(610) 860-5500
NPI assigned
Jun 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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 30144 MD
Physical Therapist 225100000X 307454 CA Primary

Addresses

Primary practice location

2211 Quarry Dr Ste E55
West Lawn, PA 19609-1161

Mailing address

301 N Lake Ave Ste 201
Pasadena, CA 91101-5120
Phone (626) 568-9115

Other practice location 1

495 N Claude A Lord Blvd
Pottsville, PA 17901-2705
Phone (570) 516-9858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241028000000 MD Practitioner - Physical Therapist in Private Practice 6800276627 Reassigns benefits to 1 organization
I20250121000843 CA Practitioner - Physical Therapist in Private Practice 6800276627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select CS Physical Therapy PCGroup PAC ID 1355742081, 177 clinicians

Practice addresses (Care Compare)

301 N Lake Ave
Suite 201
Pasadena, CA 91101-5120
Phone (626) 568-9115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Select CS Physical Therapy, P.C. Physical Therapist Current Accepting new patients
Sage Physical Therapy & Wellness LLC Physical Therapist CurrentSince Sep 5, 2024 Accepting new patients
Select CS Physical Therapy, P.C. CurrentSince Jan 6, 2025 Accepting new patients
Select CS Physical Therapy, P.C. CurrentSince Jan 6, 2025 Accepting new patients

Locations

301 N Lake Ave
Ste 201
Pasadena, CA 91101
Phone (626) 568-9030

2001 Wilshire Blvd
Ste 310
Santa Monica, CA 90403
Phone (310) 829-3320

3536A Urbana Pike
Urbana, MD 21704
Phone (301) 874-9200

Organizations & group practices 4

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": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1467181313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N LAKE AVE STE 201",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911015120",
            "telephone_number": "626-568-9115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 QUARRY DR STE E55",
            "city": "WEST LAWN",
            "state": "PA",
            "postal_code": "196091161",
            "telephone_number": "610-860-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "495 N Claude A Lord Blvd",
            "address_purpose": "LOCATION",
            "city": "Pottsville",
            "state": "PA",
            "postal_code": "179012705",
            "country_code": "US",
            "telephone_number": "570-516-9858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUNDERSEN",
        "first_name": "SYDNEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30144",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "307454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lawn, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.