Active NPI
Jeffrey C Cuevas, LPT
- Physical Therapist
- Nacogdoches, TX
National Provider Identifier
1205020047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1101582
- Practice address
- 838 N University
Suite 100
Nacogdoches, TX 75961-4898 - Phone
- (936) 552-7044
- NPI assigned
- Sep 5, 2007
- Sex
- Male
- Sole proprietor
- No
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 | 1101582 | TX | Primary |
Addresses
Primary practice location
838 N University
Suite 100
Nacogdoches, TX 75961-4898
Mailing address
4000 Mystic LN
Nacogdoches, TX 75965-6515
Phone (936) 569-0314
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8A2798 | Other | TX | PROVIDOR NUMBER |
| 7532355 | Other | TX | AETNA ID NUMBER |
| 170790301 | Medicaid | TX | |
| 8T0396 | Other | TX | BCBS PROVIDOR NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1994
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
836 N University Dr
Suite 100
Nacogdoches, TX 75961-4898
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nacogdoches Rehabilitation Group, Inc | Physical Therapist | Current | Accepting new patients |
Locations
838 N University Dr
Ste 100
Nacogdoches, TX 75961
Phone (936) 552-7044
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Nacogdoches, TX
- NPI 1164416988
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478563200000",
"number": "1205020047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 MYSTIC LN",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759656515",
"telephone_number": "936-569-0314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "838 N UNIVERSITY",
"address_2": "SUITE 100",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759614898",
"telephone_number": "936-552-7044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUEVAS",
"first_name": "JEFFREY",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "LPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-05",
"last_updated": "2016-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1101582",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDOR NUMBER",
"identifier": "8A2798",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA ID NUMBER",
"identifier": "7532355",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "170790301",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDOR NUMBER",
"identifier": "8T0396",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Nacogdoches, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.