Individual provider Active NPI

Nicholas Lucius, PT, DPT

  • Physical Therapist
  • Englewood, CO
National Provider Identifier
1619345147
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0017144 Issued in CO
Practice address
4731 S Santa Fe Cir
Englewood, CO 80110-2200
Phone
(248) 921-2282
NPI assigned
Sep 15, 2015
Reactivated
Jun 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT31338 FL
Physical Therapist 225100000X 5501017407 MI
Physical Therapist 225100000X PTL.0017144 CO Primary

Addresses

Primary practice location

4731 S Santa Fe Cir
Englewood, CO 80110-2200

Mailing address

4731 S Santa Fe Cir # 3-4
Englewood, CO 80110-2200
Phone (720) 617-6151

Other practice location 1

525 NW Peacock Blvd
Port Saint Lucie, FL 34986-2210
Phone (772) 871-2123

Other practice location 2

378 Hillsboro Technology Dr
Deerfield Beach, FL 33441-1836
Phone (954) 449-0850

Other practice location 3

44191 Plymouth Oaks Blvd
Plymouth, MI 48170-6530
Phone (734) 259-7100

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

State licenses

LicenseStateTypeSpecialty
PT31338FLMDPhysical Therapist
5501017407MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Barwismethods of Port St Lucie PastSince Mar 22, 2017 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1619345147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4731 S SANTA FE CIR # 3-4",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801102200",
            "telephone_number": "720-617-6151",
            "fax_number": "720-617-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4731 S SANTA FE CIR",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801102200",
            "telephone_number": "248-921-2282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 NW Peacock Blvd",
            "address_purpose": "LOCATION",
            "city": "Port Saint Lucie",
            "state": "FL",
            "postal_code": "349862210",
            "country_code": "US",
            "telephone_number": "772-871-2123",
            "fax_number": "772-217-4288",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "378 Hillsboro Technology Dr",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "334411836",
            "country_code": "US",
            "telephone_number": "954-449-0850",
            "fax_number": "954-246-0973",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44191 Plymouth Oaks Blvd",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MI",
            "postal_code": "481706530",
            "country_code": "US",
            "telephone_number": "734-259-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCIUS",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-15",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "deactivation_date": "2021-03-30",
        "reactivation_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT31338",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017407",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0017144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.