Individual provider Active NPI

Ruby Anna Raymundo Bulaoat, DPT

  • Physical Therapist
  • Anchorage, AK
National Provider Identifier
1538618111
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
194638 Issued in AK
Practice address
1200 Airport Heights Dr Ste 170
Anchorage, AK 99508-2986
Phone
(907) 562-2118
Fax
(907) 562-2128
NPI assigned
Sep 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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 194638 AK Primary

Addresses

Primary practice location

1200 Airport Heights Dr Ste 170
Anchorage, AK 99508-2986

Mailing address

1200 Airport Heights Dr Ste 170
Anchorage, AK 99508-2986
Phone (907) 562-2118

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230221000709 AK Practitioner - Physical Therapist in Private Practice 1759661846 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wise Physical Therapy and Rehabilitation Inc. Physical Therapist CurrentSince Feb 15, 2023 Accepting new patients
Therapist Central, Inc. Physical Therapist CurrentSince Apr 24, 2024 Accepting new patients
P.T. Hawaii, Inc Physical Therapist Past Accepting new patients

Locations

1200 Airport Heights Dr
Ste 170
Anchorage, AK 99508
Phone (907) 562-2118

12201 Industry Way
Ste 4
Anchorage, AK 99515
Phone (907) 677-9653

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": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1538618111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 AIRPORT HEIGHTS DR STE 170",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082986",
            "telephone_number": "907-562-2118",
            "fax_number": "907-562-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 AIRPORT HEIGHTS DR STE 170",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082986",
            "telephone_number": "907-562-2118",
            "fax_number": "907-562-2128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULAOAT",
        "first_name": "RUBY ANNA",
        "middle_name": "RAYMUNDO",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "194638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.