Individual provider Active NPI

Michelle Eilene Lacey, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1285984260
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
34387 Issued in AZ
Practice address
9040 Friars Rd Ste 400
San Diego, CA 92108-5862
Phone
(619) 284-6377
Fax
(619) 241-7581
NPI assigned
Sep 17, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 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 34387 AZ Primary

Addresses

Primary practice location

9040 Friars Rd Ste 400
San Diego, CA 92108-5862

Mailing address

13835 N Tatum Blvd Ste 9442
Phoenix, AZ 85032-5581
Phone (480) 666-6020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251125003275 AZ Practitioner - Physical Therapist in Private Practice 1355833492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capptcg, LLCGroup PAC ID 2668770157, 30 clinicians

Practice addresses (Care Compare)

1255 N Arizona Ave
Unit 1217
Chandler, AZ 85225-0710
Phone (602) 380-6807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Capptcg, LLC Physical Therapist CurrentSince Aug 2, 2025 Accepting new patients
Mackay Chiropractic Inc PastSince Mar 1, 2006 Accepting new patients
Blake Thompson MD Inc. PastSince Nov 17, 2019 Accepting new patients

Locations

13835 N Tatum Blvd
Ste 9442
Phoenix, AZ 85032

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1285984260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13835 N TATUM BLVD STE 9442",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850325581",
            "telephone_number": "480-666-6020",
            "fax_number": "480-666-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 FRIARS RD STE 400",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085862",
            "telephone_number": "619-284-6377",
            "fax_number": "619-241-7581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACEY",
        "first_name": "MICHELLE",
        "middle_name": "EILENE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "34387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.