Individual provider Active NPI

Lisa Palomo Bast, MPT

  • Physical Therapist
  • Fredericksburg, VA
National Provider Identifier
1376501817
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305006642 Issued in VA
Practice address
2400 Fall Hill Ave
Suite 232
Fredericksburg, VA 22401-3320
Phone
(540) 899-0500
Fax
(540) 899-7692
NPI assigned
May 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 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 2305006642 VA Primary

Addresses

Primary practice location

2400 Fall Hill Ave
Suite 232
Fredericksburg, VA 22401-3320

Mailing address

18 Gallery Rd
Stafford, VA 22554-8839
Phone (540) 899-0500

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2305006642VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1376501817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 GALLERY RD",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225548839",
            "telephone_number": "540-899-0500",
            "fax_number": "540-899-7692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 FALL HILL AVE",
            "address_2": "SUITE 232",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013320",
            "telephone_number": "540-899-0500",
            "fax_number": "540-899-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAST",
        "first_name": "LISA",
        "middle_name": "PALOMO",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305006642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.