Max Otto Selisch, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00007845 Issued in WA

Practice address

27 Colwell St
Port Hadlock, WA 98339-0897

Phone

(360) 385-9310

Fax

(360) 379-8826

NPI assigned

Jun 30, 2005

Last updated

Feb 11, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1992

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Discovery Physical Therapy Inc., P.S.

  • Physical Therapy Clinic/Center
  • Port Hadlock, WA
  • NPI 1922104926
  Medicare reassignment
• Dirksen Physical Therapy Inc PS

  • Physical Therapist
  • Port Hadlock, WA
  • NPI 1609890029
  NPD (past)
• Jefferson County Public Hospital Dist No 2

  dba Jefferson Healthcare Port Townsend Physical Therapy

  • Physical Therapist
  • Port Townsend, WA
  • NPI 1528247632
  NPD (past)
• Therapeutic Associates Inc

  dba TAI - Rock Creek

  • Physical Therapist
  • Portland, OR
  • NPI 1144042649
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1831196245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 897",
            "city": "PORT HADLOCK",
            "state": "WA",
            "postal_code": "983390897",
            "telephone_number": "360-385-9310",
            "fax_number": "360-379-8826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 COLWELL ST",
            "city": "PORT HADLOCK",
            "state": "WA",
            "postal_code": "983390897",
            "telephone_number": "360-385-9310",
            "fax_number": "360-379-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELISCH",
        "first_name": "MAX",
        "middle_name": "OTTO",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00007845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1831196245",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• David O Schores, O.D.
• Symbolyn Vera Sebastian, PTA LMP
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• Blake Thedinga, DPT
• Alice Marie Tibbals, LMHC
• Deborah Trent, PHARM.D.

• Physical Therapist in Port Hadlock, WA
• Providers in Port Hadlock, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; 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.