Individual provider Active NPI

Adriel Delacruz, DPT

  • Orthopedic Physical Therapist
  • Fairfax, VA
National Provider Identifier
1902527161
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
2305215289 Issued in VA
Practice address
10521 Rosehaven St Ste Ll150
Fairfax, VA 22030-2889
Phone
(703) 383-1616
Fax
(703) 383-1166
NPI assigned
Sep 7, 2022
Last updated
Sep 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 2305215289 VA Primary

Addresses

Primary practice location

10521 Rosehaven St Ste Ll150
Fairfax, VA 22030-2889

Mailing address

10521 Rosehaven St Ste Ll150
Fairfax, VA 22030-2889
Phone (703) 383-1616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221026000785 DC Practitioner - Physical Therapist in Private Practice 4284000613 Reassigns benefits to 2 organizations
I20230303001623 VA Practitioner - Physical Therapist in Private Practice 4284000613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Clinics Limited PartnershipGroup PAC ID 2860623295, 116 clinicians

Practice addresses (Care Compare)

43490 Yukon Dr
Ashburn, VA 20147-6990
Phone (703) 729-7920

5115 Leesburg Pike
Falls Church, VA 22041-3207
Phone (703) 824-0701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Clinics Limited Partnership Orthopedic CurrentSince Feb 10, 2023 Accepting new patients
Excel Rehabilitation, PLLC CurrentSince Sep 13, 2022 Accepting new patients

Locations

43490 Yukon Dr
Ashburn, VA 20147
Phone (703) 729-7920

10521 Rosehaven St
Ste LL150
Fairfax, VA 22030
Phone (703) 383-1616

12701 Fair Lakes Cir
Ste 102
Fairfax, VA 22033

5115 Leesburg Pike
Falls Church, VA 22041
Phone (703) 253-0022

119 The Plains Rd
Ste 100
Middleburg, VA 20117
Phone (540) 687-8181

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": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1902527161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10521 ROSEHAVEN ST STE LL150",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302889",
            "telephone_number": "703-383-1616",
            "fax_number": "703-383-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10521 ROSEHAVEN ST STE LL150",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302889",
            "telephone_number": "703-383-1616",
            "fax_number": "703-383-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELACRUZ",
        "first_name": "ADRIEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "VA",
            "license": "2305215289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.