Individual provider Active NPI

Jeffrey Lyon, PT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1043377807
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-010650 Issued in IL
Practice address
16611 S 40TH St Ste 130
Phoenix, AZ 85048-0564
Phone
(807) 061-1994
Fax
(480) 706-3999
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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 070-010650 IL Primary

Addresses

Primary practice location

16611 S 40TH St Ste 130
Phoenix, AZ 85048-0564

Mailing address

16611 S 40TH St Ste 130
Phoenix, AZ 85048-0564
Phone (480) 706-1199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240609000066 AZ Practitioner - Physical Therapist in Private Practice 8224277611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spooner Physical Therapy and Hand Rehab, PCGroup PAC ID 3476440447, 202 clinicians

Practice addresses (Care Compare)

16611 S 40TH St
Suite 130
Phoenix, AZ 85048-0564
Phone (480) 706-1199

Merit-based Incentive Payment System (MIPS)

Final score
85.61 of 100Reported as group
Quality
90
Improvement activities
40
Cost
70.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-010650ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spooner Physical Therapy & Hand Rehab, PC Current Accepting new patients
Spooner Physical Therapy & Hand Rehab, PC CurrentSince May 23, 2024 Accepting new patients
Spooner Physical Therapy and Hand Rehab, PC Physical Therapist CurrentSince May 23, 2024 Accepting new patients
Spooner Physical Therapy & Hand Rehab, PC Past Accepting new patients

Locations

16611 S 40th St
Ste 130
Phoenix, AZ 85048
Phone (480) 706-1199

9097 E Desert Cove Ave
Ste 110
Scottsdale, AZ 85260
Phone (480) 860-4298

14287 N 87th St
Ste 220
Scottsdale, AZ 85260

Organizations & group practices 4

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1043377807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16611 S 40TH ST STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480564",
            "telephone_number": "480-706-1199",
            "fax_number": "480-706-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16611 S 40TH ST STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480564",
            "telephone_number": "807-061-1994",
            "fax_number": "480-706-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYON",
        "first_name": "JEFFREY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-010650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.