Active NPI
Theresa Ann Lust, DPT
- Physical Therapist
- Media, PA
National Provider Identifier
1104194950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT020049
- Practice address
- 1118 W Baltimore Pike
Ste 302
Media, PA 19063-6104 - Phone
- (610) 744-2600
- NPI assigned
- Dec 8, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT020049 | PA | Primary |
Addresses
Primary practice location
1118 W Baltimore Pike
Ste 302
Media, PA 19063-6104
Mailing address
1118 W Baltimore Pike
Ste 302
Media, PA 19063-6104
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reconstructive Orthopaedic Associates II LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- Philadelphia, PA
- NPI 1861433278
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349740800000",
"number": "1104194950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1118 W BALTIMORE PIKE",
"address_2": "STE 302",
"city": "MEDIA",
"state": "PA",
"postal_code": "190636104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1118 W BALTIMORE PIKE",
"address_2": "STE 302",
"city": "MEDIA",
"state": "PA",
"postal_code": "190636104",
"telephone_number": "610-744-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUST",
"first_name": "THERESA",
"middle_name": "ANN",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-08",
"last_updated": "2012-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT020049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Media, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.