Individual provider Active NPI

Siddharth Damodaran

  • Physical Therapist
  • Denton, TX
National Provider Identifier
1518756014
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5017 Teasley LN Ste 161
Denton, TX 76210-3895
Phone
(940) 220-2283
Fax
(254) 249-1733
NPI assigned
May 2, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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 TX Primary

Addresses

Primary practice location

5017 Teasley LN Ste 161
Denton, TX 76210-3895

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250618003945 TX Practitioner - Physical Therapist in Private Practice 2264943950 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
Ideal Physical Therapy of Texas LLCGroup PAC ID 0547583809, 359 clinicians

Practice addresses (Care Compare)

5017 Teasley LN
Suite 161
Denton, TX 76210-3895
Phone (940) 220-2283

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC CurrentSince Jun 9, 2025 Accepting new patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Jun 9, 2025 Accepting new patients

Locations

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

3000 FM 407 E
Ste 500
Bartonville, TX 76226
Phone (940) 448-2007

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

5017 Teasley Ln
Ste 161
Denton, TX 76210
Phone (940) 220-2283

1050 Flower Mound Rd
Ste 140
Flower Mound, TX 75028
Phone (469) 702-5947

1288 W Main St
Ste 148
Lewisville, TX 75067
Phone (469) 496-3992

5400 Brodie Ln
Ste 295
Sunset Valley, TX 78745
Phone (512) 676-3949

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": "1746144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1518756014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5017 TEASLEY LN STE 161",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762103895",
            "telephone_number": "940-220-2283",
            "fax_number": "254-249-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMODARAN",
        "first_name": "SIDDHARTH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-02",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.