Active NPI
Nicholas Lucius, PT, DPT
- Physical Therapist
- Englewood, CO
National Provider Identifier
1619345147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTL.0017144
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| PT31338 | FL | MD | Physical Therapist |
| 5501017407 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barwismethods of Port St Lucie | Past | 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.
-
- Rehabilitation Clinic/Center
- Port Saint Lucie, FL
- NPI 1497102016
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.