Lucas S Suydam, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02172100 Issued in NJ

Practice address

1050 US Highway 1
Avenel, NJ 07001-1548

Phone

(732) 283-2663

Fax

(732) 283-2661

NPI assigned

May 31, 2023

Last updated

Oct 28, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthonj LLCGroup PAC ID 6800225178, 302 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Orthonj LLC

  • Orthopaedic Surgery Physician
  • Somerset, NJ
  • NPI 1720557432
  Medicare reassignment Care Compare group NPD
• Ivyrehab Network Inc.

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1174577274
  Medicare reassignment NPD
• Ivyrehab Network, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Cranford, NJ
  • NPI 1699590265

  Physical Therapist

  NPD
• Orthonj LLC

  • Durable Medical Equipment & Medical Supplies
  • Galloway, NJ
  • NPI 1487448312
  NPD

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1083307599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 US HIGHWAY 1",
            "city": "AVENEL",
            "state": "NJ",
            "postal_code": "070011548",
            "telephone_number": "732-283-2663",
            "fax_number": "732-283-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 US HIGHWAY 1",
            "city": "AVENEL",
            "state": "NJ",
            "postal_code": "070011548",
            "telephone_number": "732-283-2663",
            "fax_number": "732-283-2661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 City Hall Plz Ste 3023",
            "address_purpose": "LOCATION",
            "city": "Rahway",
            "state": "NJ",
            "postal_code": "070655075",
            "country_code": "US",
            "telephone_number": "732-381-3636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUYDAM",
        "first_name": "LUCAS",
        "middle_name": "S",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-31",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02172100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• State of New Jersey Omb Centralized Payroll (Woodbridge Developmental Center)
• Christopher M Stewart, D.D.S
• Florence Stewart, LPN
• Stuart M Homer MD PA
• Regina Sudziute, D.D.S
• Alexander M Swan, MD
• Samina Altaf Syed-Naqvi, M.D.
• Jazmine Tatis, LSW
• Ken Thaher, DMD
• The Arc Middlesex County

• Physical Therapist in Avenel, NJ
• Providers in Avenel, NJ by specialty
• Physical Therapist in New Jersey

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