Individual provider Active NPI

David Lee Seitz, PT

  • Physical Therapist
  • La Crosse, WI
National Provider Identifier
1730249632
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3318-24 Issued in WI
Practice address
N1418 Timber Valley Rd
La Crosse, WI 54601-2172
Phone
(608) 787-6386
Fax
(608) 788-4543
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3318024 WI
Physical Therapist 225100000X 3318-24 WI Primary

Addresses

Primary practice location

N1418 Timber Valley Rd
La Crosse, WI 54601-2172

Mailing address

N1418 Timber Valley Rd
La Crosse, WI 54601-2172
Phone (608) 787-6386

Other identifiers 2

IdentifierTypeStateIssuer
3318024OtherWIPT LICENSE
40140900MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210618000338 WI Practitioner - Physical Therapist in Private Practice 9638080401 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3318-24WIMDPhysical Therapist
3318024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Valley Physical Rehabilitation S.C. Physical Therapist CurrentSince Mar 1, 2003 Accepting new patients

Locations

2501 Shelby Rd
La Crosse, WI 54601
Phone (608) 519-9801

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1730249632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N1418 TIMBER VALLEY RD",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546012172",
            "telephone_number": "608-787-6386",
            "fax_number": "608-788-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N1418 TIMBER VALLEY RD",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546012172",
            "telephone_number": "608-787-6386",
            "fax_number": "608-788-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEITZ",
        "first_name": "DAVID",
        "middle_name": "LEE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3318024",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3318-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "3318024",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40140900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.