Individual provider Active NPI

Lucas Christensen, P.T.

  • Physical Therapist
  • Mesa, AZ
National Provider Identifier
1013323443
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3048 E Baseline Rd
Suite 125
Mesa, AZ 85204-7286
Phone
(480) 222-0655
Fax
(480) 222-1457
NPI assigned
Jul 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X WA Primary
Physical Therapist 225100000X 10982 AZ

Addresses

Primary practice location

3048 E Baseline Rd
Suite 125
Mesa, AZ 85204-7286

Mailing address

4631 Whitman LN SE
Ste D
Lacey, WA 98513-2250
Phone (630) 296-2223

Other identifiers 1

IdentifierTypeStateIssuer
946863MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141001002373 AZ Practitioner - Physical Therapist in Private Practice 0648490391 Reassigns benefits to 1 organization
I20190910000584 WA Practitioner - Physical Therapist in Private Practice 0648490391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yelm Physical Therapy Services Inc PSGroup PAC ID 5395963490, 9 clinicians

Practice addresses (Care Compare)

417 W Yelm Ave
PO Box 765
Yelm, WA 98597-7679
Phone (440) 225-9147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1013323443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4631 WHITMAN LN SE",
            "address_2": "STE D",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985132250",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3048 E BASELINE RD",
            "address_2": "SUITE 125",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047286",
            "telephone_number": "480-222-0655",
            "fax_number": "480-222-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "LUCAS",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-07",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "10982",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "946863",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.