RAPHAEL AUGUSTUS SADIWA (PT, DPT) – Physical Therapist, NPI 1063245561

RAPHAEL AUGUSTUS SADIWA (PT, DPT) is a healthcare provider. based in Southlake, Texas. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 1104404 (TX). The NPI Number for RAPHAEL AUGUSTUS SADIWA (PT, DPT) is 1063245561

Main info

Male
19 Years Of Experience
Accepts Medicare Assignment
Name
RAPHAEL AUGUSTUS SADIWA (PT, DPT)
NPI
1063245561
Phone
(866) 839-6979
Address
180 STATE ST STE 225
Enumeration Date
21 August 2024
Last Update Date
21 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8665253175
Graduation Year
2007 (19 years ago)
PAC ID
8123004827
Group Practice PAC ID
0648692723
Professional Enrollment ID
I20040624001290
Address ID
TX760927632SO180XXSTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

5,399 PHYSICAL THERAPIST IN PRIVATE PRACTICE in TX

Provider Addresses for RAPHAEL AUGUSTUS SADIWA (PT, DPT)

  • 180 STATE ST STE 225

    SOUTHLAKE, TX 760927632

    Phone: (866) 839-6979

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-06-24

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040624001290IPhysical Therapist In Private PracticeTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 76092)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648692723View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMN
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeRI
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX

Reviews

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Frequently asked questions

Does RAPHAEL AUGUSTUS SADIWA (PT, DPT) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — RAPHAEL AUGUSTUS SADIWA (PT, DPT) uses 1063245561.
Is RAPHAEL AUGUSTUS SADIWA (PT, DPT) still practicing?
RAPHAEL AUGUSTUS SADIWA (PT, DPT) is currently listed as active in the public NPI registry.
What healthcare role does RAPHAEL AUGUSTUS SADIWA (PT, DPT) hold?
Scheduling teams often label RAPHAEL AUGUSTUS SADIWA (PT, DPT) under Physical Therapist. Clinical services aligned with this taxonomy classification.
Does RAPHAEL AUGUSTUS SADIWA (PT, DPT) list a practice location?
Patients near Southlake, Texas may find RAPHAEL AUGUSTUS SADIWA (PT, DPT) in results; validate coverage separately.
Why does RAPHAEL AUGUSTUS SADIWA (PT, DPT) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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