Individual provider Active NPI

Alejandra Maria Prusaitis, LMT, CD

  • Massage Therapist
  • Kyle, TX
National Provider Identifier
1023736683
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT136048 Issued in TX
Practice address
250 Primrose Blvd
Kyle, TX 78640-4219
Phone
(512) 855-1780
NPI assigned
Aug 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Doula 374J00000X
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X MT136048 TX Primary

Addresses

Primary practice location

250 Primrose Blvd
Kyle, TX 78640-4219

Mailing address

250 Primrose Blvd
Kyle, TX 78640-4219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MT136048TXMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1023736683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PRIMROSE BLVD",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786404219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PRIMROSE BLVD",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786404219",
            "telephone_number": "512-855-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSAITIS",
        "first_name": "ALEJANDRA",
        "middle_name": "MARIA",
        "credential": "LMT, CD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT136048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kyle, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.