Individual provider Active NPI

Jackeline Rubio

  • Physical Therapist
  • Cypress, TX
National Provider Identifier
1336915297
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1386131 Issued in TX
Practice address
10523 Fry Rd Ste 100
Cypress, TX 77433-5348
Phone
(281) 256-8956
NPI assigned
Nov 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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
Physical Therapist 225100000X 1386131 TX Primary

Addresses

Primary practice location

10523 Fry Rd Ste 100
Cypress, TX 77433-5348

Mailing address

20221 Longenbaugh Road
Apt 5310
Cypress, TX 77433
Phone (917) 474-8865

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240110001563 TX Practitioner - Physical Therapist in Private Practice 6204287675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10523 Fry Rd
Suite 100
Cypress, TX 77433-5348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1386131TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Texas Limited Partnership Physical Therapist CurrentSince Dec 1, 2023 Accepting new patients

Locations

10523 Fry Rd
#100
Cypress, TX 77433
Phone (281) 256-8956

711 W Bay Area Blvd
Ste 608
Webster, TX 77598
Phone (281) 338-1273

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": "1701302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1336915297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20221 LONGENBAUGH ROAD",
            "address_2": "APT 5310",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "77433",
            "telephone_number": "917-474-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10523 FRY RD STE 100",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774335348",
            "telephone_number": "281-256-8956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIO",
        "first_name": "JACKELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1386131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.