Active NPI
Benjie Simbolas Severino, PT
- Physical Therapist
- Fresno, CA
National Provider Identifier
1710143615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT33983
- Practice address
- 6061 N 1St St
Suite 104
Fresno, CA 93710-5470 - Phone
- (559) 435-6905
- NPI assigned
- Jul 31, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT33983 | CA | Primary |
Addresses
Primary practice location
6061 N 1St St
Suite 104
Fresno, CA 93710-5470
Mailing address
6061 N 1St St
Suite 104
Fresno, CA 93710-5470
Phone (559) 435-6905
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Therapy Inc | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217462400000",
"number": "1710143615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6061 N 1ST ST",
"address_2": "SUITE 104",
"city": "FRESNO",
"state": "CA",
"postal_code": "937105470",
"telephone_number": "559-435-6905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6061 N 1ST ST",
"address_2": "SUITE 104",
"city": "FRESNO",
"state": "CA",
"postal_code": "937105470",
"telephone_number": "559-435-6905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEVERINO",
"first_name": "BENJIE",
"middle_name": "SIMBOLAS",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-31",
"last_updated": "2008-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT33983",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.