Individual provider Active NPI

Madison Horton Lacienski, PT, DPT

  • Physical Therapist
  • Savannah, GA
National Provider Identifier
1144708249
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT013563 Issued in GA
Practice address
210 E Derenne Ave
Savannah, GA 31405-6736
Phone
(912) 644-5300
Fax
(912) 644-5241
NPI assigned
Jul 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT013563 GA Primary

Addresses

Primary practice location

210 E Derenne Ave
Savannah, GA 31405-6736

Mailing address

210 E Derenne Ave
Savannah, GA 31405-6736
Phone (912) 644-5300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181023003718 GA Practitioner - Physical Therapist in Private Practice 0446503395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optim Orthopedics LLCGroup PAC ID 9931427002, 101 clinicians

Practice addresses (Care Compare)

210 E Derenne Ave
Savannah, GA 31405-6736
Phone (912) 644-5300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT013563GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Aug 13, 2018 Accepting new patients
Optim Orthopedics, LLC CurrentSince Feb 1, 2021 Accepting new patients
Independent Physical Therapy of Ga, LLC Physical Therapist CurrentSince Aug 13, 2018 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist Current Accepting new patients
Optim Orthopedics, LLC CurrentSince Feb 1, 2021 Accepting new patients
Optim Orthopedics, LLC Past Accepting new patients
Optim Orthopedics, LLC PastSince Oct 6, 2019 Accepting new patients
Independent Physical Therapy of Ga, LLC Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

10200 Ford Ave
Ste 105
Richmond Hill, GA 31324
Phone (912) 348-9500

461 Johnny Mercer Blvd
Ste C7
Savannah, GA 31410
Phone (912) 231-3619

461 Johnny Mercer Blvd
Ste C2
Savannah, GA 31410
Phone (912) 231-3619

210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

Interoperability endpoints

  • Direct secure messaging: madison.horton.1@16403.direct.athenahealth.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1144708249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E DERENNE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056736",
            "telephone_number": "912-644-5300",
            "fax_number": "912-644-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E DERENNE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056736",
            "telephone_number": "912-644-5300",
            "fax_number": "912-644-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACIENSKI",
        "first_name": "MADISON",
        "middle_name": "HORTON",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; 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.