Individual provider Active NPI

Kyle Thomas Lacasse, DPT

  • Physical Therapist
  • Newton, MA
National Provider Identifier
1386048817
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
425 Centre St
Newton, MA 02458-2063
Phone
(617) 244-1990
NPI assigned
Oct 13, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X RI
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

425 Centre St
Newton, MA 02458-2063

Mailing address

250 E Main St
Norton, MA 02766-2436
Phone (578) 444-1005

Other practice location 1

1 Garnett Lane
Greenville, RI 02828
Phone (401) 949-0380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, MD, DC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210923001139 MA Practitioner - Physical Therapist in Private Practice 3375844632 Reassigns benefits to 1 organization
I20250814003389 MD Practitioner - Physical Therapist in Private Practice 3375844632 Reassigns benefits to 1 organization
I20250828004123 DC Practitioner - Physical Therapist in Private Practice 3375844632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
4 Oaks Physical Therapy, LLCGroup PAC ID 1759604838, 18 clinicians

Practice addresses (Care Compare)

21 Mellor Ave
Catonsville, MD 21228-5106
Phone (443) 251-2760

4201 Mitchellville Rd
Suite 100
Bowie, MD 20716-3122
Phone (301) 464-5444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25233MAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
4 Oaks Physical Therapy, LLC. Single Specialty CurrentSince Jun 16, 2025 Accepting new patients
Bay State Physical Therapy PC Single Specialty CurrentSince Oct 1, 2023 Accepting new patients
Marathon Physical Therapy and Sports Medicine, LLC Single Specialty CurrentSince Aug 23, 2021 Accepting new patients
Marathon Physical Therapy and Sports Medicine, LLC Single Specialty PastSince Aug 23, 2021 Accepting new patients

Locations

425 Centre St
Newton, MA 02458
Phone (617) 244-1990

250 E Main St
Norton, MA 02766
Phone (508) 285-5533

99 Vanderbilt Ave
Norwood, MA 02062
Phone (781) 352-5400

4201 Mitchellville Rd
Ste 100
Bowie, MD 20716
Phone (301) 464-5444

21 Mellor Ave
Catonsville, MD 21228
Phone (443) 251-2760

2000 Century Plz
Columbia, MD 21044
Phone (410) 740-4802

1 Garnett Ln
Greenville, RI 02828
Phone (401) 949-0380

Organizations & group practices 4

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": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1386048817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E MAIN ST",
            "city": "NORTON",
            "state": "MA",
            "postal_code": "027662436",
            "telephone_number": "578-444-1005",
            "fax_number": "085-285-4483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 CENTRE ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024582063",
            "telephone_number": "617-244-1990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Garnett Lane",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "RI",
            "postal_code": "02828",
            "country_code": "US",
            "telephone_number": "401-949-0380",
            "fax_number": "401-949-5581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACASSE",
        "first_name": "KYLE",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-13",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.