Active NPI
Mohammed N Sedique, PTA
- Physical Therapist
- Newport Beach, CA
National Provider Identifier
1609002393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT5525
- Practice address
- 4341 Birch Street, Suite #102
Selective Rehab
Newport Beach, CA 92660 - Phone
- (949) 250-7870
- Fax
- (949) 475-1003
- NPI assigned
- Jun 8, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5525 | CA | |
| Physical Therapist | 225100000X | PT5525 | CA | Primary |
Addresses
Primary practice location
4341 Birch Street, Suite #102
Selective Rehab
Newport Beach, CA 92660
Mailing address
4341 Birch Street, Suite #102
Selective Rehab
Newport Beach, CA 92660
Phone (949) 250-7870
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT5525 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ace Consulting Group | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247184000000",
"number": "1609002393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4341 BIRCH STREET, SUITE #102",
"address_2": "SELECTIVE REHAB",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "92660",
"telephone_number": "949-250-7870",
"fax_number": "949-475-1003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4341 BIRCH STREET, SUITE #102",
"address_2": "SELECTIVE REHAB",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "92660",
"telephone_number": "949-250-7870",
"fax_number": "949-475-1003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEDIQUE",
"first_name": "MOHAMMED",
"middle_name": "N",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-08",
"last_updated": "2009-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "5525",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT5525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.