Individual provider Active NPI

Ruth Valerie Baltazar, PT

  • Physical Therapist
  • Scottsbluff, NE
National Provider Identifier
1306282504
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3194 Issued in NE
Practice address
111 W 36TH St
Scottsbluff, NE 69361-4636
Phone
(308) 635-2019
NPI assigned
May 14, 2013
Last updated
May 14, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2013

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 3194 NE Primary

Addresses

Primary practice location

111 W 36TH St
Scottsbluff, NE 69361-4636

Mailing address

222 W 18TH St
Apt D
Scottsbluff, NE 69361-2306
Phone (513) 405-9320

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240403001719 IL Practitioner - Physical Therapist in Private Practice 7517305022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cortlyn Therapy PCGroup PAC ID 8729495684, 141 clinicians

Practice addresses (Care Compare)

1611 Chicago Ave
Evanston, IL 60201-6019
Phone (224) 394-5810

2801 Old Glenview Rd
Wilmette, IL 60091-3075
Phone (224) 601-8430

4950 N Ashland Ave
Chicago, IL 60640-3477
Phone (312) 598-2030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3194NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cortlyn Therapy, PC Physical Therapist CurrentSince Feb 21, 2024 Accepting new patients

Locations

28100 Torch Pkwy
Ste 600
Warrenville, IL 60555
Phone (630) 413-5817

7125 Janes Ave
Ste 300
Woodridge, IL 60517
Phone (630) 413-5817

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, 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": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368489600000",
    "number": "1306282504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W 18TH ST",
            "address_2": "APT D",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693612306",
            "telephone_number": "513-405-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W 36TH ST",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614636",
            "telephone_number": "308-635-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTAZAR",
        "first_name": "RUTH",
        "middle_name": "VALERIE",
        "name_prefix": "Miss",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-14",
        "last_updated": "2013-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "3194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsbluff, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; 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.