Active NPI
Stacey Lu Takeshita, PT
- Physical Therapist
- Frisco, TX
National Provider Identifier
1154561785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1303240
- Practice address
- 5480 FM 423 Ste 2100
Frisco, TX 75036-7914 - Phone
- (214) 494-4643
- NPI assigned
- Feb 23, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 35267 | CA | |
| Physical Therapist | 225100000X | 1303240 | TX | Primary |
Addresses
Primary practice location
5480 FM 423 Ste 2100
Frisco, TX 75036-7914
Mailing address
200 Newport Center Dr
#213
Newport Beach, CA 92660-7501
Phone (949) 644-1322
Other practice location 1
2888 Long Beach Blvd
#405
Long Beach, CA 90806-1530
Phone (562) 595-4489
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EK468Z | Other | CA | MEDICARE PTAN |
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 |
|---|---|---|---|
| 35267 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vista Rehab Partners, LP | Physical Therapist | Past | Accepting new patients |
| Vista Rehab Partners, LP | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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
- Prosper, TX
- NPI 1659716462
-
- Physical Therapist
- Ft Worth, TX
- NPI 1710223318
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580169600000",
"number": "1154561785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 NEWPORT CENTER DR",
"address_2": "#213",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926607501",
"telephone_number": "949-644-1322",
"fax_number": "949-644-0316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5480 FM 423 STE 2100",
"city": "FRISCO",
"state": "TX",
"postal_code": "750367914",
"telephone_number": "214-494-4643"
}
],
"practiceLocations": [
{
"address_1": "2888 Long Beach Blvd",
"address_2": "#405",
"address_purpose": "LOCATION",
"city": "Long Beach",
"state": "CA",
"postal_code": "908061530",
"country_code": "US",
"telephone_number": "562-595-4489",
"fax_number": "562-595-4063",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LU TAKESHITA",
"first_name": "STACEY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-23",
"last_updated": "2020-01-28",
"certification_date": "2020-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "35267",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1303240",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "EK468Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Frisco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.