Individual provider Active NPI

Arle Troy Ceniza Jumalon, PT

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1902363344
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2285 Issued in NV
Practice address
10401 West Charleston Blvd
Las Vegas, NV 89135
Phone
(702) 496-9802
NPI assigned
Feb 21, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2285 NV Primary

Addresses

Primary practice location

10401 West Charleston Blvd
Las Vegas, NV 89135

Mailing address

4614 Erin Glen St
Las Vegas, NV 89147-7253
Phone (702) 224-4889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241031003719 NV Practitioner - Physical Therapist in Private Practice 8628501400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premere Rehab LLCGroup PAC ID 2567434764, 12 clinicians

Practice addresses (Care Compare)

10401 W Charleston Blvd
Las Vegas, NV 89135-1151
Phone (702) 207-4242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2285NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premere Rehab LLC Physical Therapist CurrentSince May 20, 2023 Accepting new patients

Locations

8100 SW Nyberg St
Ste 200
Tualatin, OR 97062
Phone (503) 570-3365

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1902363344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4614 ERIN GLEN ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891477253",
            "telephone_number": "702-224-4889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10401 WEST CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89135",
            "telephone_number": "702-496-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUMALON",
        "first_name": "ARLE TROY",
        "middle_name": "CENIZA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-21",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "2285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; 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.

Verify at the official NPI Registry.