Individual provider Active NPI

Maria Elizabeth Santalucia

  • Physical Therapist
  • Roanoke, VA
National Provider Identifier
1093147464
Registry record updated Aug 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305208153 Issued in VA
Practice address
4633 Brambleton Ave
Suite 202
Roanoke, VA 24018-3410
Phone
(540) 774-0729
Fax
(540) 774-0862
NPI assigned
Aug 7, 2013
Last updated
Aug 7, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2013

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 2305208153 VA Primary

Addresses

Primary practice location

4633 Brambleton Ave
Suite 202
Roanoke, VA 24018-3410

Mailing address

4633 Brambleton Ave
Suite 202
Roanoke, VA 24018-3410
Phone (540) 774-0729

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305208153VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1093147464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4633 BRAMBLETON AVE",
            "address_2": "SUITE 202",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183410",
            "telephone_number": "540-774-0729",
            "fax_number": "540-774-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4633 BRAMBLETON AVE",
            "address_2": "SUITE 202",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183410",
            "telephone_number": "540-774-0729",
            "fax_number": "540-774-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTALUCIA",
        "first_name": "MARIA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-07",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; 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.