Individual provider Active NPI

Juventino Ruiz Jr., OTR

  • Occupational Therapist
  • McAllen, TX
National Provider Identifier
1710173471
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
111838 Issued in TX
Practice address
5215 N McColl Rd
McAllen, TX 78504-2202
Phone
(956) 803-0033
Fax
(956) 683-6448
NPI assigned
Sep 17, 2007
Last updated
Aug 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 111838 TX Primary

Addresses

Primary practice location

5215 N McColl Rd
McAllen, TX 78504-2202

Mailing address

616 Vida Santa St
Alamo, TX 78516-2014
Phone (956) 533-4390

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
111838TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Squad, LLC CurrentSince Aug 2, 2020 Accepting new patients
Functional Therapeutics PastSince Aug 9, 2020 Accepting new patients

Locations

5215 N McColl Rd
McAllen, TX 78504
Phone (956) 533-4390

711 W Nolana Ave
Ste 204A
McAllen, TX 78504
Phone (956) 803-0033

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": "1189987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1710173471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 VIDA SANTA ST",
            "city": "ALAMO",
            "state": "TX",
            "postal_code": "785162014",
            "telephone_number": "956-533-4390",
            "fax_number": "956-683-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 N MCCOLL RD",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785042202",
            "telephone_number": "956-803-0033",
            "fax_number": "956-683-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "JUVENTINO",
        "name_suffix": "Jr.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-17",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "111838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.