Individual provider Active NPI

Lisa Mariko Sellers-Simon, M.S.P.T.

  • Physical Therapist
  • Webster, TX
National Provider Identifier
1609204221
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1118362 Issued in TX
Practice address
251 W Medical Center Blvd Ste 240
Webster, TX 77598-4242
Phone
(281) 724-0300
Fax
(281) 724-0310
NPI assigned
Oct 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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 1118362 TX Primary

Addresses

Primary practice location

251 W Medical Center Blvd Ste 240
Webster, TX 77598-4242

Mailing address

10223 Broadway St Ste B
Pearland, TX 77584-7881
Phone (713) 436-3900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140415001496 TX Practitioner - Physical Therapist in Private Practice 9436381985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Physical Therapy Centers, PLLCGroup PAC ID 8022926492, 9 clinicians

Practice addresses (Care Compare)

251 W Medical Ctr Blvd
Suite 240
Webster, TX 77598-4242
Phone (281) 724-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Physical Therapy Centers, PLLC Physical Therapist CurrentSince Jun 28, 2013 Accepting new patients

Locations

4600 Fairmont Pkwy
Ste 205
Pasadena, TX 77504
Phone (281) 998-8600

10223 Broadway St
Ste B
Pearland, TX 77584
Phone (713) 436-3900

8850 Six Pines Dr
Ste 290
Shenandoah, TX 77380
Phone (281) 364-8844

251 W Medical Center Blvd
Ste 240
Webster, TX 77598
Phone (281) 724-0300

250 Blossom St
Ste 240
Webster, TX 77598
Phone (281) 724-0300

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": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1609204221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10223 BROADWAY ST STE B",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847881",
            "telephone_number": "713-436-3900",
            "fax_number": "173-436-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 W MEDICAL CENTER BLVD STE 240",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984242",
            "telephone_number": "281-724-0300",
            "fax_number": "281-724-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLERS-SIMON",
        "first_name": "LISA",
        "middle_name": "MARIKO",
        "name_prefix": "Mrs.",
        "credential": "M.S.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-16",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1118362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.