Roxanne Marie Cruciani, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2928-19 Issued in WI

Practice address

41 East County Road C, #211
Little Canada, MN 55117

Phone

(612) 986-1738

NPI assigned

Dec 17, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1871958827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23443 JOHN NELSON RD",
            "city": "SIREN",
            "state": "WI",
            "postal_code": "548728462",
            "telephone_number": "612-986-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 EAST COUNTY ROAD C, #211",
            "city": "LITTLE CANADA",
            "state": "MN",
            "postal_code": "55117",
            "telephone_number": "612-986-1738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Maple ridge care center",
            "address_2": "510 1st street",
            "address_purpose": "LOCATION",
            "city": "spooner",
            "state": "WI",
            "postal_code": "54801",
            "country_code": "US",
            "telephone_number": "715-635-1415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUCIANI",
        "first_name": "ROXANNE",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-17",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A1317",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2928-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Little Canada, MN
• Providers in Little Canada, MN by specialty
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.