Individual provider Active NPI

Ruel Santos Lucas, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1114552742
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045641 Issued in NY
Practice address
150 Riverside Dr
New York, NY 10024-2298
Phone
(646) 505-3500
NPI assigned
Mar 4, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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 045641 NY Primary

Addresses

Primary practice location

150 Riverside Dr
New York, NY 10024-2298

Mailing address

258 E 105TH St Apt 3B
New York, NY 10029-4747
Phone (646) 379-4801

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210212001051 NY Practitioner - Physical Therapist in Private Practice 0345655973 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045641NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Esd PT OT & SLP PLLC Physical Therapist CurrentSince Mar 1, 2023 Accepting new patients
Link Home Therapy Services of Ny-PT OT SLP PLLC CurrentSince Jan 28, 2021 Accepting new patients

Locations

180 Sylvan Ave
Ste 4
Englewood Cliffs, NJ 07632
Phone (347) 841-8943

2632 Atlantic Ave
Brooklyn, NY 11207
Phone (718) 473-3803

108 S Franklin Ave
Ste 10
Valley Stream, NY 11580

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1114552742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 E 105TH ST APT 3B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294747",
            "telephone_number": "646-379-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 RIVERSIDE DR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100242298",
            "telephone_number": "646-505-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "RUEL",
        "middle_name": "SANTOS",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.