Individual provider Active NPI

Tara L Lasuzzo, M.P.T.

  • Physical Therapist
  • Monroe, LA
National Provider Identifier
1073695383
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
09495R Issued in LA
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, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 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 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

IdentifierTypeStateIssuer
2443887MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161021000923 LA Practitioner - Physical Therapist in Private Practice 7012010291 Reassigns benefits to 2 organizations

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
Geaux Physical TherapyGroup PAC ID 9032528088, 2 clinicians

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 100Reported as apm
Quality
60.04
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09495RLAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Health Group, LLC Physical Therapist CurrentSince May 8, 2017 Accepting new patients
Geaux Physical Therapy Physical Therapist CurrentSince Jan 28, 2024 Accepting new patients
Affinity Health Group, LLC CurrentSince May 8, 2017 Accepting new patients
Jackson Parish Therapy Center LLC Physical Therapist PastSince Sep 22, 2016 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

  • FHIR API: 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.

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.

Verify at the official NPI Registry.