Individual provider Active NPI

Isaac Salinas Cosculluela

  • Physical Therapist
  • Blue Ash, OH
National Provider Identifier
1194106377
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-020694 Issued in OH
Practice address
9525 Kenwood Rd Ste 10a
Blue Ash, OH 45242-6177
Phone
(513) 745-9877
NPI assigned
Jun 14, 2015
Last updated
Sep 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Physical Therapist 225100000X PT-020694 OH Primary
Athletic Trainer 2255A2300X NU

Addresses

Primary practice location

9525 Kenwood Rd Ste 10a
Blue Ash, OH 45242-6177

Mailing address

7567 Central Parke Blvd Ste a
Mason, OH 45040-6855
Phone (513) 701-6104

Other practice location 1

11003 Montgomery Rd Ste A
Cincinnati, OH 45249-2306
Phone (513) 469-1444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260408000043 AZ Practitioner - Physical Therapist in Private Practice 6507331535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4850 E Baseline Rd
Suite 114
Mesa, AZ 85206-4626

8783 Bluebird Dr
West Chester, OH 45069-3460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-020694OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oxford Physical Therapy and Rehabilitation Physical Therapist PastSince Sep 24, 2023 Accepting new patients

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, 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": "1434240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1194106377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7567 CENTRAL PARKE BLVD STE A",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450406855",
            "telephone_number": "513-701-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9525 KENWOOD RD STE 10A",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452426177",
            "telephone_number": "513-745-9877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11003 Montgomery Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452492306",
            "country_code": "US",
            "telephone_number": "513-469-1444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSCULLUELA",
        "first_name": "ISAAC",
        "middle_name": "SALINAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-14",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT-020694",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Ash, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.