Lyle Daniel Dsouza, DPT
Individual provider Active NPI Physical Therapist · Fernley, NV
NPI 1699314583 · NPPES record last updated Dec 26, 2019
Key facts
- NPI
- 1699314583
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 3720 (NV)
- Practice address
- 20 West St
Fernley, NV 89408-9799 - Phone
- (775) 575-5508
- NPI assigned
- Dec 26, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hull Physical Therapy LLC
Fernley Physical Therapy Inc
Practice addresses (Care Compare)
20 W St
Fernley, NV 89408-9799
Phone (775) 575-5508
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200401001688 | NV | Practitioner - Physical Therapist in Private Practice | 2567891294 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3720 | NV | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hull Physical Therapy LLC | Physical Therapist | Current |
Accepting new patients |
| Fernley Physical Therapy, Inc. | Single Specialty | Current |
Accepting new patients |
Locations
20 West St
Fernley, NV 89408
Phone (775) 575-5508
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist |
2251G0304X | 3720 | NV | |
| Physical Therapist |
225100000X | 3720 | NV | Yes |
Addresses
Primary practice location
20 West St
Fernley, NV 89408-9799
Mailing address
20 West St
Fernley, NV 89408-9799
Phone (775) 575-5508
Other practice location 1
3101 Plumas St
Reno, NV 89509-4515
Phone (775) 829-7220
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ldsouza@llu.edu |
Other providers in Fernley, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.