Individual provider Active NPI

Philip Aurelio Secondez, DPT

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1770182685
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
61065289 Issued in WA
Practice address
3221 Eastlake Ave E Ste 110
Seattle, WA 98102-7125
Phone
(206) 641-3272
NPI assigned
Oct 21, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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 61065289 WA Primary

Addresses

Primary practice location

3221 Eastlake Ave E Ste 110
Seattle, WA 98102-7125

Mailing address

4802 S Ryan Way
Tukwila, WA 98178-2035
Phone (415) 312-7574

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210121002017 WA Practitioner - Physical Therapist in Private Practice 7810301405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apple Physical Therapy LLCGroup PAC ID 7810892072, 285 clinicians

Practice addresses (Care Compare)

25012 104TH Ave SE
Suite C
Kent, WA 98030-2821
Phone (253) 856-3477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61065289WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Dec 21, 2020 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist CurrentSince Dec 21, 2020 Accepting new patients
Pro Sport Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2024 Accepting new patients

Locations

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

5160 Borgen Blvd
Ste 101
Gig Harbor, WA 98332
Phone (253) 853-4000

12926 SE Kent Kangley Rd
Kent, WA 98030
Phone (253) 216-1041

25012 104th Ave SE
Ste C
Kent, WA 98030
Phone (253) 856-3477

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

Organizations & group practices 3

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": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1770182685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 S RYAN WAY",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981782035",
            "telephone_number": "415-312-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3221 EASTLAKE AVE E STE 110",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981027125",
            "telephone_number": "206-641-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SECONDEZ",
        "first_name": "PHILIP",
        "middle_name": "AURELIO",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "61065289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.