Individual provider Active NPI

Lucas R Paggiaro Simoes, DPT

  • Physical Therapist
  • Cameron, NC
National Provider Identifier
1124343645
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P13659 Issued in NC
Practice address
1562 Highway 24/87
Cameron, NC 28326-9424
Phone
(910) 436-4545
Fax
(910) 497-2222
NPI assigned
Mar 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P13659 NC Primary
Physical Therapist 225100000X 8825 AZ

Addresses

Primary practice location

1562 Highway 24/87
Cameron, NC 28326-9424

Mailing address

981 High House Rd Ste 100
Cary, NC 27513-3510
Phone (919) 388-0111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120828000455 NC Practitioner - Physical Therapist in Private Practice 7618169632 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Rehabilitation IncGroup PAC ID 8628018843, 11 clinicians
Breakthrough Physical Therapy IncGroup PAC ID 9234274754, 110 clinicians

Practice addresses (Care Compare)

1010 High House Rd
Suite 105
Cary, NC 27513-3576
Phone (502) 609-4872

1562 Hwy 24/87
Cameron, NC 28326
Phone (910) 436-4545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8825AZMDPhysical Therapist
P13659NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Breakthrough Physical Therapy Inc Physical Therapist CurrentSince Jul 2, 2012 Accepting new patients
Carolina Rehabilitation Inc Physical Therapist CurrentSince Nov 1, 2025 Accepting new patients
Ati Holdings of Arizona, LLC Physical Therapist PastSince Mar 1, 2016 Accepting new patients
Breakthrough Physical Therapy Physical Therapist Past Accepting new patients
Ideal Rehabilitation LLC Past Accepting new patients

Locations

852 Perry Rd
Apex, NC 27502
Phone (919) 446-5670

3814 Rural Retreat Rd
Ste 103
Burlington, NC 27215
Phone (743) 241-3020

981 High House Rd
#100
Cary, NC 27513
Phone (919) 388-0111

1010 High House Rd
Ste 105
Cary, NC 27513
Phone (919) 415-1318

530 Sandhurst Dr
Fayetteville, NC 28304
Phone (910) 483-9300

1910 N Church St
Ste D
Greensboro, NC 27405
Phone (336) 274-7480

303 N 35th St
Morehead City, NC 28557
Phone (252) 247-2738

20 Medical Campus Dr NW
Ste 204
Supply, NC 28462
Phone (910) 612-1002

Organizations & group practices 5

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": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1124343645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 HIGH HOUSE RD STE 100",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275133510",
            "telephone_number": "919-388-0111",
            "fax_number": "919-388-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1562 HIGHWAY 24/87",
            "city": "CAMERON",
            "state": "NC",
            "postal_code": "283269424",
            "telephone_number": "910-436-4545",
            "fax_number": "910-497-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMOES",
        "first_name": "LUCAS",
        "middle_name": "R PAGGIARO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-29",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P13659",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "8825",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cameron, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.