Individual provider Active NPI

Gregory Rupp, PT, DPT

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1235886474
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4786 Issued in NV
Practice address
1333 N Buffalo Dr Unit 170
Las Vegas, NV 89128-3637
Phone
(702) 564-6712
NPI assigned
Mar 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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 4786 NV Primary

Addresses

Primary practice location

1333 N Buffalo Dr Unit 170
Las Vegas, NV 89128-3637

Mailing address

2660 N Buffalo Dr Unit 1160
Las Vegas, NV 89128-4827
Phone (510) 789-8330

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220324001326 NV Practitioner - Physical Therapist in Private Practice 3779978994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brandon Jackson P TGroup PAC ID 2961480363, 9 clinicians

Practice addresses (Care Compare)

5550 Painted Mirage Rd
Suite 120
Las Vegas, NV 89149-4582
Phone (702) 898-7633

Merit-based Incentive Payment System (MIPS)

Final score
58.17 of 100Reported as group
Quality
37.51
Improvement activities
40
Cost
75.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brandon Jackson, P T Physical Therapist CurrentSince Jun 9, 2025 Accepting new patients
Brandon Jackson PT Past Accepting new patients
Therapy West LLC Physical Therapist Past Accepting new patients

Locations

5550 Painted Mirage Rd
Ste 120
Las Vegas, NV 89149
Phone (702) 898-7633

4765 S Durango Dr
Ste 106
Las Vegas, NV 89147
Phone (702) 898-7633

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": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1235886474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 N BUFFALO DR UNIT 1160",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891284827",
            "telephone_number": "510-789-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 N BUFFALO DR UNIT 170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891283637",
            "telephone_number": "702-564-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPP",
        "first_name": "GREGORY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-08",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "4786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.