Individual provider Active NPI

Carl Ruth, DPT

  • Physical Therapist
  • Orlando, FL
National Provider Identifier
1376923656
Registry record updated Jun 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30367 Issued in FL
Practice address
5671 S Orange Ave
Orlando, FL 32809-4291
Phone
(407) 888-2255
NPI assigned
Jun 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2015

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 30367 FL Primary

Addresses

Primary practice location

5671 S Orange Ave
Orlando, FL 32809-4291

Mailing address

5671 S Orange Ave
Orlando, FL 32809-4291
Phone (407) 888-2255

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160308002191 FL Practitioner - Physical Therapist in Private Practice 9931405552 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy Specialists of Hunters Creek LLCGroup PAC ID 1355576745, 6 clinicians

Practice addresses (Care Compare)

7300 Sandlake Commons Blvd
Suite 305
Orlando, FL 32819-8022
Phone (407) 802-4514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30367FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Specialists of Pine Castle LLC Physical Therapist CurrentSince Jul 30, 2015 Accepting new patients
Physical Therapy Specialists of Hunters Creek, LLC Physical Therapist CurrentSince Jul 1, 2017 Accepting new patients
Durable Medical Equipment Specialists Past Accepting new patients

Locations

7300 Sandlake Commons Blvd
Ste 305
Orlando, FL 32819
Phone (407) 802-4514

5671 S Orange Ave
Orlando, FL 32809
Phone (407) 888-2255

14115 Town Loop Blvd
Ste 200
Orlando, FL 32837
Phone (407) 601-3922

345 W Michigan St
Ste 108
Orlando, FL 32806
Phone (407) 745-4633

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": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433203200000",
    "number": "1376923656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5671 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328094291",
            "telephone_number": "407-888-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5671 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328094291",
            "telephone_number": "407-888-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTH",
        "first_name": "CARL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "30367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; 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.