Active NPI
Tara L Lasuzzo, M.P.T.
- Physical Therapist
- Monroe, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 09495R
- Practice address
- 1325 Louisville Ave
Monroe, LA 71201 - Phone
- (318) 807-1500
- Fax
- (318) 807-1504
- NPI assigned
- Oct 19, 2006
- Last updated
- Jun 12, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT4063 | MS | |
| Physical Therapist | 225100000X | 09495R | LA | Primary |
Addresses
Primary practice location
1325 Louisville Ave
Monroe, LA 71201
Mailing address
130 Desiard St Ste 355
Monroe, LA 71201-7363
Phone (318) 807-7875
Other practice location 1
65 Dutch Ln
Columbus, MS 39702-5523
Phone (662) 241-4545
Other practice location 2
1325 Louisville Ave
Monroe, LA 71201
Phone (318) 807-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2443887 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3801 Chauvin LN
Monroe, LA 71201-1911
Phone (318) 512-9445
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.51 of 100
- Quality
- 60.04
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09495R | LA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affinity Health Group, LLC | Physical Therapist | Current | Accepting new patients |
| Geaux Physical Therapy | Physical Therapist | Current | Accepting new patients |
| Affinity Health Group, LLC | Current | Accepting new patients | |
| Jackson Parish Therapy Center LLC | Physical Therapist | Past | Accepting new patients |
Locations
130 Desiard St
Ste 355
Monroe, LA 71201
Phone (318) 807-7875
1325 Louisville Ave
Monroe, LA 71201
Phone (318) 807-1500
2408 Broadmoor Blvd
Ste 2
Monroe, LA 71201
Phone (318) 807-0525
3801 Chauvin Ln
Monroe, LA 71201
Phone (318) 387-2352
Interoperability endpoints
- https://api.platform.athenahealth.com/22651/brand/1/csg/1/fhir/r4
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Affinity Orthopaedic Clinic
- Orthopaedic Surgery Physician
- Monroe, LA
- NPI 1861879249
-
dba Fyzical Therapy & Balance Centers
- Physical Therapist
- Ruston, LA
- NPI 1891794491
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560297600000",
"number": "1073695383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 DESIARD ST STE 355",
"city": "MONROE",
"state": "LA",
"postal_code": "712017363",
"telephone_number": "318-807-7875",
"fax_number": "318-812-6603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 LOUISVILLE AVE",
"city": "MONROE",
"state": "LA",
"postal_code": "71201",
"telephone_number": "318-807-1500",
"fax_number": "318-807-1504"
}
],
"practiceLocations": [
{
"address_1": "65 Dutch Ln",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "MS",
"postal_code": "397025523",
"country_code": "US",
"telephone_number": "662-241-4545",
"fax_number": "662-241-4025",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1325 Louisville Ave",
"address_purpose": "LOCATION",
"city": "Monroe",
"state": "LA",
"postal_code": "71201",
"country_code": "US",
"telephone_number": "318-807-1500",
"fax_number": "318-807-1504",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LASUZZO",
"first_name": "TARA",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "M.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-19",
"last_updated": "2019-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MS",
"license": "PT4063",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "09495R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2443887",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.