Individual provider Active NPI

Jose Rene Ruiz, DPT

  • Physical Therapist
  • San Antonio, TX
National Provider Identifier
1306386230
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1389506 Issued in TX
Practice address
11703 Huebner Rd Ste 100
San Antonio, TX 78230-1211
Phone
(210) 612-0492
Fax
(210) 319-7075
NPI assigned
Feb 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1389506 TX Primary
Athletic Trainer 2255A2300X TX

Addresses

Primary practice location

11703 Huebner Rd Ste 100
San Antonio, TX 78230-1211

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424

Other practice location 1

1207 Jodobo Dr
Eagle Pass, TX 78852-3318
Phone (830) 968-2874

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240328001031 TX Practitioner - Physical Therapist in Private Practice 3476990219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Practice addresses (Care Compare)

11703 Huebner Rd
Suite 100
San Antonio, TX 78230-1211
Phone (210) 612-0492

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1389506TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA Inc Physical Therapist CurrentSince Feb 26, 2024 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Feb 26, 2024 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1335 E Whitestone Blvd
#100
Cedar Park, TX 78613
Phone (512) 539-0032

11703 Huebner Rd
Ste 100
San Antonio, TX 78230
Phone (210) 612-0492

Organizations & group practices 2

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": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1306386230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11703 HUEBNER RD STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301211",
            "telephone_number": "210-612-0492",
            "fax_number": "210-319-7075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1207 Jodobo Dr",
            "address_purpose": "LOCATION",
            "city": "Eagle Pass",
            "state": "TX",
            "postal_code": "788523318",
            "country_code": "US",
            "telephone_number": "830-968-2874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "JOSE",
        "middle_name": "RENE",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-24",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1389506",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.