Individual provider Active NPI

Lauren Marie Ontiveros, PT, DPT

  • Physical Therapist
  • Palestine, TX
National Provider Identifier
1528859865
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1200858 Issued in TX
Practice address
3201 S Loop 256
Palestine, TX 75801-6901
Phone
(903) 661-7057
NPI assigned
May 15, 2025
Last updated
Jul 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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 1200858 TX Primary
Neurology Physical Therapist 2251N0400X 1200858 TX

Addresses

Primary practice location

3201 S Loop 256
Palestine, TX 75801-6901

Mailing address

18038 Lookout Vly
Flint, TX 75762-9602
Phone (915) 309-3382

Other practice location 1

1327 Troup Hwy
Tyler, TX 75701-4443
Phone (903) 606-2111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250731002456 TX Practitioner - Physical Therapist in Private Practice 9133637218 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1200858TXMDNeurology Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Aug 25, 2025 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Aug 25, 2025 Accepting new patients

Locations

3201 S Loop 256
Palestine, TX 75801
Phone (903) 723-0330

1327 Troup Hwy
Tyler, TX 75701
Phone (903) 510-8764

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

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, 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": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1528859865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18038 LOOKOUT VLY",
            "city": "FLINT",
            "state": "TX",
            "postal_code": "757629602",
            "telephone_number": "915-309-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 S LOOP 256",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758016901",
            "telephone_number": "903-661-7057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1327 Troup Hwy",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757014443",
            "country_code": "US",
            "telephone_number": "903-606-2111",
            "fax_number": "903-606-2113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONTIVEROS",
        "first_name": "LAUREN",
        "middle_name": "MARIE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-15",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1200858",
            "primary": true
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "TX",
            "license": "1200858",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palestine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; 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.