Active NPI
Luis Lares, PT, DPT
- Physical Therapist
- Capitol Heights, MD
National Provider Identifier
1114456167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305211115
- Practice address
- 9141 Alaking CT
Capitol Heights, MD 20743-5043 - Phone
- (301) 499-4655
- Fax
- (301) 499-0902
- NPI assigned
- Jun 5, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305211115 | VA | Primary |
Addresses
Primary practice location
9141 Alaking CT
Capitol Heights, MD 20743-5043
Mailing address
1160 1St St NE Apt 346
Washington, DC 20002-4793
Phone (702) 716-9701
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2305211115 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496620800000",
"number": "1114456167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1160 1ST ST NE APT 346",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200024793",
"telephone_number": "702-716-9701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9141 ALAKING CT",
"city": "CAPITOL HEIGHTS",
"state": "MD",
"postal_code": "207435043",
"telephone_number": "301-499-4655",
"fax_number": "301-499-0902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARES",
"first_name": "LUIS",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-05",
"last_updated": "2017-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305211115",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Capitol Heights, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.