Individual provider Active NPI

Brady Tuckner, P.T.

  • Physical Therapist
  • Mesa, AZ
National Provider Identifier
1407710361
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP051811T Issued in AZ
Practice address
10165 E Hampton Ave Ste 111
Mesa, AZ 85209-3327
Phone
(480) 354-5424
NPI assigned
Dec 15, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 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 CP051811T AZ Primary

Addresses

Primary practice location

10165 E Hampton Ave Ste 111
Mesa, AZ 85209-3327

Mailing address

10165 E Hampton Ave Ste 111
Mesa, AZ 85209-3327

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260622003133 WA Practitioner - Physical Therapist in Private Practice 7012480049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

9521 Gravelly Lake Dr SW
Lakewood, WA 98499-1513
Phone (253) 983-9395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP051811TAZMDPhysical Therapist

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": "1765756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1407710361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10165 E HAMPTON AVE STE 111",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10165 E HAMPTON AVE STE 111",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093327",
            "telephone_number": "480-354-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKNER",
        "first_name": "BRADY",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-12-15",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "CP051811T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.