Individual provider Active NPI

Sean Casey Ryan, P.T.

  • Physical Therapist
  • Redondo Beach, CA
National Provider Identifier
1730286410
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 29414 Issued in CA
Practice address
1912 S Pacific Coast Hwy
Redondo Beach, CA 90277-6118
Phone
(310) 540-5758
Fax
(310) 540-5404
NPI assigned
Sep 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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 PT 29414 CA Primary

Addresses

Primary practice location

1912 S Pacific Coast Hwy
Redondo Beach, CA 90277-6118

Mailing address

1912 S Pacific Coast Hwy
Redondo Beach, CA 90277-6118
Phone (310) 540-5758

Other practice location 1

8830 S Sepulveda Blvd
Los Angeles, CA 90045-4833
Phone (310) 540-5758

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100624000234 CA Practitioner - Physical Therapist in Private Practice 2668503350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Positive Energy Physical Therapy IncGroup PAC ID 9739362781, 6 clinicians

Practice addresses (Care Compare)

1912 S Pacific Coast Hwy
Redondo Beach, CA 90277-6118
Phone (310) 540-5758

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 29414CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Energy Physical Therapy Inc Physical Therapist CurrentSince Jan 3, 2011 Accepting new patients
South Bay Sports Medicine Physical Therapy Inc. Physical Therapist PastSince Mar 2, 2001 Accepting new patients

Locations

1912 S Pacific Coast Hwy
Redondo Beach, CA 90277
Phone (310) 309-2091

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, 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": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1730286410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 S PACIFIC COAST HWY",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902776118",
            "telephone_number": "310-540-5758",
            "fax_number": "310-540-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 S PACIFIC COAST HWY",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902776118",
            "telephone_number": "310-540-5758",
            "fax_number": "310-540-5404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8830 S Sepulveda Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900454833",
            "country_code": "US",
            "telephone_number": "310-540-5758",
            "fax_number": "310-540-5404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "SEAN",
        "middle_name": "CASEY",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 29414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.