Individual provider Active NPI

Gamal H. Renteria-Lucius, RPT

  • Physical Therapist
  • Tulsa, OK
National Provider Identifier
1245392505
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1939 Issued in OK
Practice address
5950 E 31St St
Tulsa, OK 74135-5114
Phone
(918) 851-5072
Fax
(918) 619-6077
NPI assigned
Dec 14, 2006
Last updated
Jul 20, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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 1939 OK Primary

Addresses

Primary practice location

5950 E 31St St
Tulsa, OK 74135-5114

Mailing address

2318 S 109TH East Ave
Tulsa, OK 74129-5030
Phone (918) 851-5072

Other names 1

  • Mrs. Gamal H. Lucius Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1939OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Rehab Services, Inc. Past Accepting new patients
Microvas Treatment Centers of America Past Accepting new patients
Envida Rehabilitation LLC Physical Therapist Past Accepting new patients

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, 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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184889600000",
    "number": "1245392505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2318 S 109TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741295030",
            "telephone_number": "918-851-5072",
            "fax_number": "918-619-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355114",
            "telephone_number": "918-851-5072",
            "fax_number": "918-619-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTERIA-LUCIUS",
        "first_name": "GAMAL",
        "middle_name": "H.",
        "name_prefix": "Mrs.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "1939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAMAL",
            "last_name": "LUCIUS",
            "middle_name": "H.",
            "prefix": "MRS.",
            "credential": "RPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.