Individual provider Active NPI

Jeffrey C Cuevas, LPT

  • Physical Therapist
  • Nacogdoches, TX
National Provider Identifier
1205020047
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1101582 Issued in TX
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

Updated by the provider on Nov 8, 2016

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 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

IdentifierTypeStateIssuer
8A2798OtherTXPROVIDOR NUMBER
7532355OtherTXAETNA ID NUMBER
170790301MedicaidTX
8T0396OtherTXBCBS PROVIDOR NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120606000762 TX Practitioner - Physical Therapist in Private Practice 4587826292 Reassigns benefits to 1 organization

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

OrganizationSpecialtyStatusNew patients
Nacogdoches Rehabilitation Group, Inc Physical Therapist CurrentSince Dec 3, 2002 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.

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.

Verify at the official NPI Registry.