Individual provider Active NPI

Lesley Ruby, OT

  • Occupational Therapist
  • Twin Falls, ID
National Provider Identifier
1114081569
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-242 Issued in ID
Practice address
840 Addison Ave
Twin Falls, ID 83301-5203
Phone
(208) 595-4941
Fax
(208) 595-4931
NPI assigned
Dec 20, 2006
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X OT-242 ID
Orthotic Fitter 225000000X OT-242 ID
Occupational Therapist 225X00000X OT-242 ID Primary

Addresses

Primary practice location

840 Addison Ave
Twin Falls, ID 83301-5203

Mailing address

840 Addison Ave
Twin Falls, ID 83301-5203
Phone (208) 595-4941

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070801000650 ID Practitioner - Occupational Therapist in Private Practice 0749371029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

840 Addison Ave
Twin Falls, ID 83301-5203
Phone (208) 595-4941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT-242IDMDOrthotic Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Physical Rehabilitation, LLC PastSince Jun 1, 2007 Accepting new patients
Active Hand and Physical Rehabilitation LP PastSince Jan 2, 2009 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1114081569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 ADDISON AVE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015203",
            "telephone_number": "208-595-4941",
            "fax_number": "208-595-4931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 ADDISON AVE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015203",
            "telephone_number": "208-595-4941",
            "fax_number": "208-595-4931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBY",
        "first_name": "LESLEY",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "ID",
            "license": "OT-242",
            "primary": false
        },
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "ID",
            "license": "OT-242",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT-242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.