Individual provider Active NPI

Luke Brubaker, MS,OTRL

  • Occupational Therapist
  • Brighton, MI
National Provider Identifier
1164009403
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201010972 Issued in MI
Practice address
7200 Challis Rd
Brighton, MI 48116-7411
Phone
(810) 227-0119
NPI assigned
Mar 24, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201010972 MI Primary

Addresses

Primary practice location

7200 Challis Rd
Brighton, MI 48116-7411

Mailing address

31048 Dorchester Apt 165
New Hudson, MI 48165-9442
Phone (419) 605-5043

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240619001489 OH Practitioner - Occupational Therapist in Private Practice 0042614810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brain Bright Therapy LLCGroup PAC ID 0042588709, 5 clinicians

Practice addresses (Care Compare)

5164 Monroe St
Toledo, OH 43623-3471
Phone (419) 410-4341

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Brain Bright Therapy LLC CurrentSince May 1, 2024 Accepting new patients
A Renewed Mind PastSince May 1, 2024 Accepting new patients
Special Tree Rehabilitation Services LTD Past Accepting new patients

Locations

5164 Monroe St
Toledo, OH 43623
Phone (419) 359-5300

5412 Monroe St
Ste 1
Toledo, OH 43623
Phone (419) 279-9576

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1164009403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31048 DORCHESTER APT 165",
            "city": "NEW HUDSON",
            "state": "MI",
            "postal_code": "481659442",
            "telephone_number": "419-605-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 CHALLIS RD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481167411",
            "telephone_number": "810-227-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUBAKER",
        "first_name": "LUKE",
        "credential": "MS,OTRL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201010972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.