Individual provider Active NPI

Monioluwa Otubaga, DPT

  • Physical Therapist
  • Katy, TX
National Provider Identifier
1467121731
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1345683 Issued in TX
Practice address
2002 W Grand Pkwy N Ste 125
Katy, TX 77449-2518
Phone
(281) 710-9001
Fax
(281) 697-6703
NPI assigned
Sep 9, 2021
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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 1345683 TX Primary

Addresses

Primary practice location

2002 W Grand Pkwy N Ste 125
Katy, TX 77449-2518

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

21630 Merchants Way
Katy, TX 77449-2514
Phone (832) 230-1518

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address admin@reliantpediatrictherapy.com Direct

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

Practice roles

OrganizationSpecialtyStatusNew patients
Origin Physical Therapy FL PLLC Physical Therapist CurrentSince Oct 8, 2024 Accepting new patients

Locations

12411 Hymeadow Dr
Ste 3B
Austin, TX 78750
Phone (512) 250-8497

4950 Terminal St
Ste 100
Bellaire, TX 77401
Phone (832) 307-0894

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": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1467121731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 W GRAND PKWY N STE 125",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774492518",
            "telephone_number": "281-710-9001",
            "fax_number": "281-697-6703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21630 Merchants Way",
            "address_purpose": "LOCATION",
            "city": "Katy",
            "state": "TX",
            "postal_code": "774492514",
            "country_code": "US",
            "telephone_number": "832-230-1518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTUBAGA",
        "first_name": "MONIOLUWA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1345683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@reliantpediatrictherapy.com",
            "affiliation": "N",
            "endpointDescription": "Laptop, Desktop",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21630 Merchants Way",
            "city": "Katy",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774492514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.