Individual provider Active NPI

Sean Kevin Callahan, R.P.T.

  • Orthopedic Physical Therapist
  • Covina, CA
National Provider Identifier
1639191901
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT 25293 Issued in CA
Practice address
234 N Citrus Ave
Covina, CA 91723-2003
Phone
(626) 331-0077
Fax
(626) 331-0067
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT 25293 CA Primary

Addresses

Primary practice location

234 N Citrus Ave
Covina, CA 91723-2003

Mailing address

234 N Citrus Ave
Covina, CA 91723-2003
Phone (626) 331-0077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120314000324 CA Practitioner - Physical Therapist in Private Practice 6103996517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Five Star Physical Therapy, Inc.Group PAC ID 2062794126, 3 clinicians

Practice addresses (Care Compare)

234 N Citrus Ave
PT 360
Covina, CA 91723-2003
Phone (626) 331-0077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 25293CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Five Star Physical Therapy, Inc. Orthopedic CurrentSince Dec 19, 2016 Accepting new patients
Star Physical Therapy of Santa Maria, Inc. Orthopedic PastSince May 1, 2008 Accepting new patients

Locations

234 N Citrus Ave
Covina, CA 91723
Phone (626) 331-0077

234 N Citrus Ave
#360
Covina, CA 91723
Phone (626) 331-0077

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1639191901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 N CITRUS AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917232003",
            "telephone_number": "626-331-0077",
            "fax_number": "626-331-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 N CITRUS AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917232003",
            "telephone_number": "626-331-0077",
            "fax_number": "626-331-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "SEAN",
        "middle_name": "KEVIN",
        "credential": "R.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT 25293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

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