Individual provider Active NPI

Lucas Edmund Pratt, DPT

  • Orthopedic Physical Therapist
  • Del Mar, CA
National Provider Identifier
1407190937
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
39584 Issued in CA
Practice address
12865 Pointe del Mar Way Ste 190
Del Mar, CA 92014-3860
Phone
(844) 316-7979
Fax
(866) 813-1235
NPI assigned
Nov 21, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 39584 CA Primary

Addresses

Primary practice location

12865 Pointe del Mar Way Ste 190
Del Mar, CA 92014-3860

Mailing address

7525 Metropolitan Dr Ste 1306
San Diego, CA 92108-4411
Phone (844) 316-7979

Other identifiers 1

IdentifierTypeStateIssuer
39584OtherCAPT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201208001243 CA Practitioner - Physical Therapist in Private Practice 3274945746 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
Gaspar Physical Therapy a Professional CorporationGroup PAC ID 0648165761, 38 clinicians

Practice addresses (Care Compare)

6221 Metropolitan St
Suite 101
Carlsbad, CA 92009-3096
Phone (760) 707-5080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39584CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gaspar Physical Therapy a Professional Corporation Orthopedic CurrentSince Nov 21, 2023 Accepting new patients
Gaspar Physical Therapy a Professional Corporation CurrentSince Nov 21, 2023 Accepting new patients
Water and Sports Physical Therapy Past Accepting new patients
Spinezone Medical Fitness, Inc. Orthopedic PastSince Jul 28, 2021 Accepting new patients
Gaspar Physical Therapy a Professional Corporation Past Accepting new patients
Livara Health Medical Group NJ, PC Past Accepting new patients

Locations

6221 Metropolitan St
Ste 101
Carlsbad, CA 92009
Phone (760) 632-6942

3809 Plaza Dr
Ste 112
Oceanside, CA 92056
Phone (760) 941-2630

3609 Ocean Ranch Blvd
Ste 201
Oceanside, CA 92056
Phone (760) 941-2630

981 Lomas Santa Fe Dr
Ste A
Solana Beach, CA 92075
Phone (858) 794-9995

Organizations & group practices 6

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": "1353456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1407190937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7525 METROPOLITAN DR STE 1306",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084411",
            "telephone_number": "844-316-7979",
            "fax_number": "866-813-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12865 POINTE DEL MAR WAY STE 190",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920143860",
            "telephone_number": "844-316-7979",
            "fax_number": "866-813-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "LUCAS",
        "middle_name": "EDMUND",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-21",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "39584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "39584",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Del Mar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.