Active NPI
Ma Lourdes Juliano
- Geriatric Physical Therapist
- Crown Point, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 05003806A
- Practice address
- 1175 Luther Dr
Crown Point, IN 46307-5054 - Phone
- (219) 663-3860
- NPI assigned
- Oct 15, 2021
- Last updated
- May 19, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05003806A | IN | |
| Geriatric Physical Therapist | 2251G0304X | 05003806A | IN | Primary |
Addresses
Primary practice location
1175 Luther Dr
Crown Point, IN 46307-5054
Mailing address
2313 Foliage LN
Dyer, IN 46311-1978
Phone (219) 333-1402
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ, IN
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4300 Cleveland Ave
Michigan City, IN 46360-7683
Phone (219) 872-6800
7500 N Calle Sin Envidia
Tucson, AZ 85718-7300
Phone (520) 742-6242
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05003806A | IN | MD | Geriatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Select Rehabilitation, LLC | Physical Therapist | Current | Accepting new patients |
Locations
13391 N 94th Dr
Peoria, AZ 85381
Phone (623) 232-9841
13822 S 46th Pl
Phoenix, AZ 85044
Phone (480) 598-1224
475 N Niles Ave
South Bend, IN 46617
Phone (574) 246-4123
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Rehabilitation Clinic/Center
- Glenview, IL
- NPI 1346368248
AZ, IN, Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779148800000",
"number": "1871256909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2313 FOLIAGE LN",
"city": "DYER",
"state": "IN",
"postal_code": "463111978",
"telephone_number": "219-333-1402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 LUTHER DR",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463075054",
"telephone_number": "219-663-3860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JULIANO",
"first_name": "MA LOURDES",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-15",
"last_updated": "2026-05-19",
"certification_date": "2026-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05003806A",
"primary": false
},
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "IN",
"license": "05003806A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Crown Point, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.