Active NPI
Melvin John Pontoy Luces, PT
- Physical Therapist
- Decatur, IL
National Provider Identifier
1811137037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070015575
- Practice address
- 444 W Harrison Ave
Decatur, IL 62526-4157 - Phone
- (217) 877-7333
- NPI assigned
- Feb 27, 2009
- Last updated
- Feb 27, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070015575 | IL | Primary |
Addresses
Primary practice location
444 W Harrison Ave
Decatur, IL 62526-4157
Mailing address
2490 Country TRL
Apt 110
Decatur, IL 62526-3967
Phone (217) 619-1385
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070015575 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235692800000",
"number": "1811137037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2490 COUNTRY TRL",
"address_2": "APT 110",
"city": "DECATUR",
"state": "IL",
"postal_code": "625263967",
"telephone_number": "217-619-1385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "444 W HARRISON AVE",
"city": "DECATUR",
"state": "IL",
"postal_code": "625264157",
"telephone_number": "217-877-7333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCES",
"first_name": "MELVIN JOHN",
"middle_name": "PONTOY",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-02-27",
"last_updated": "2009-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070015575",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.