Active NPI
Steven Brett Lundeen, PT
- Physical Therapist
- Gilbert, AZ
National Provider Identifier
1104901743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2587
- Practice address
- 1079 N Arroyo LN
Gilbert, AZ 85234-2943 - Phone
- (480) 287-3828
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- 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 | 2587 | AZ | Primary |
Addresses
Primary practice location
1079 N Arroyo LN
Gilbert, AZ 85234-2943
Mailing address
1079 N Arroyo LN
Gilbert, AZ 85234-2943
Phone (480) 287-3828
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 579849 | Medicaid | AZ |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2587 | AZ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Skyline Physical Therapy Aquatics and Rehab Specialists | Physical Therapist | 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.
-
- Physical Therapist
- Apache Junction, AZ
- NPI 1720022346
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489449600000",
"number": "1104901743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1079 N ARROYO LN",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852342943",
"telephone_number": "480-287-3828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1079 N ARROYO LN",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852342943",
"telephone_number": "480-287-3828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDEEN",
"first_name": "STEVEN",
"middle_name": "BRETT",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2017-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "2587",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "579849",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.