NPIMap

Organization Active NPI

La Luz Therapy Services

  • Physical Therapy Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1104366533
Registry record updated Nov 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
4196 Issued in NM
Legal business name
LA LUZ THERAPY SERVICES
Practice address
5400 Sevilla Ave NW Ste E
Albuquerque, NM 87120-1853
Phone
(505) 363-9582
Fax
(505) 214-5137
NPI assigned
Mar 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2019

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

Authorized official

Name
Marisa RoddyNPI 1972853026
Title
Owner
Phone
(505) 363-9582

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 4197 NM
Physical Therapy Clinic/Center 261QP2000X 4196 NM Primary

Addresses

Primary practice location

5400 Sevilla Ave NW Ste E
Albuquerque, NM 87120-1853

Mailing address

1312 Mesa Wood PL NW
Albuquerque, NM 87120-6565

Other identifiers 2

IdentifierTypeStateIssuer
1972853026OtherNMNPI
1730501883OtherNMNPI

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://laluztherapy.wixsite.com/la-luz

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191108001321 NM Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0749612943 Receives reassigned benefits from 4 practitioners
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

5400 Sevilla Ave NW
Ste E
Albuquerque, NM 87120
Phone (505) 363-9582

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1488585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575072000000",
    "number": "1104366533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 MESA WOOD PL NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871206565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 SEVILLA AVE NW STE E",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201853",
            "telephone_number": "505-363-9582",
            "fax_number": "505-214-5137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA LUZ THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-04",
        "last_updated": "2019-11-30",
        "status": "A",
        "authorized_official_last_name": "RODDY",
        "authorized_official_first_name": "MARISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-363-9582"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NM",
            "license": "4197",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NM",
            "license": "4196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1972853026",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1730501883",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://laluztherapy.wixsite.com/la-luz",
            "affiliation": "N",
            "address_1": "5400 Sevilla Ave NW Ste E",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871201853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.