Individual provider Active NPI

Luke Lettinga

  • Physical Therapist
  • Pismo Beach, CA
National Provider Identifier
1255721015
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
291530 Issued in CA
Practice address
108 Holly Way
Pismo Beach, CA 93449-3221
Phone
(616) 560-8671
NPI assigned
Feb 2, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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 291530 CA Primary

Addresses

Primary practice location

108 Holly Way
Pismo Beach, CA 93449-3221

Mailing address

108 Holly Way
Pismo Beach, CA 93449-3221
Phone (616) 560-8671

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260506003742 CA Practitioner - Physical Therapist in Private Practice 4183941008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

108 Holly Way
Pismo Beach, CA 93449-3221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
291530CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lettinga DPT LLC Current 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.

NPI Registry JSON

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

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1255721015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 HOLLY WAY",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493221",
            "telephone_number": "616-560-8671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 HOLLY WAY",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493221",
            "telephone_number": "616-560-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETTINGA",
        "first_name": "LUKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-02",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "291530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pismo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; 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.