Individual provider Active NPI

Paul Robert Lanusse, RPT, OTR/L

  • Physical Therapist
  • Lake Mary, FL
National Provider Identifier
1487690467
Registry record updated Nov 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT21068 Issued in FL
Practice address
864 Blairmont LN
Lake Mary, FL 32746-7027
Phone
(321) 662-9269
Fax
(407) 386-6132
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2007

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 PT21068 FL Primary
Physical Therapist 225100000X 5501012670 MI

Addresses

Primary practice location

864 Blairmont LN
Lake Mary, FL 32746-7027

Mailing address

4133 Cummings St
Orlando, FL 32828-4889
Phone (321) 662-9269

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040924000069 FL Practitioner - Physical Therapist in Private Practice 3375511579 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT21068FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Feb 21, 2022 Accepting new patients
Florida Luna Care Physical Therapy LLC Physical Therapist CurrentSince Aug 25, 2021 Accepting new patients
Stern at Home Physical Therapy PC Physical Therapist CurrentSince Sep 19, 2021 Accepting new patients
Legacy Healthcare Services, Inc Physical Therapist CurrentSince Feb 21, 2022 Accepting new patients
Home Rehab Solutions LLC Physical Therapist PastSince Jan 22, 2018 Accepting new patients
Home Rehab Solutions of Michigan LLC Physical Therapist Past Accepting new patients
Dedicated Physical Therapy and Wellness LLC Physical Therapist PastSince Jun 27, 2021 Accepting new patients

Locations

2219 Chiquita Blvd S
Cape Coral, FL 33991
Phone (239) 205-3654

5011 Gate Pkwy
Ste 100
Jacksonville, FL 32256
Phone (904) 326-3627

8213 Killearn Lakes Ter
Tallahassee, FL 32312
Phone (850) 391-0979

38130 Pretty Pond Rd
Zephyrhills, FL 33540
Phone (813) 400-2291

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

4 Medical Park Dr
Ste B
Pomona, NY 10970
Phone (845) 354-3131

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 7

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194825600000",
    "number": "1487690467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4133 CUMMINGS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284889",
            "telephone_number": "321-662-9269",
            "fax_number": "407-386-6132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "864 BLAIRMONT LN",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327467027",
            "telephone_number": "321-662-9269",
            "fax_number": "407-386-6132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANUSSE",
        "first_name": "PAUL",
        "middle_name": "ROBERT",
        "credential": "RPT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT21068",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012670",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.