Lucas A Kunze, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501018634 Issued in MI

Practice address

N5241 US Hwy
Watersmeet, MI 49969-4996

Phone

(906) 358-4588

NPI assigned

Aug 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lac Vieux Desert Band of Lake Superior Chippewa IndiansGroup PAC ID 2567629181, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lac Vieux Desert Band of Lake Superior Chippewa Indians

  dba LVD Health Center

  • Federally Qualified Health Center (FQHC)
  • Watersmeet, MI
  • NPI 1114071578

  TX

  Medicare reassignment Care Compare group NPD
• Accelerated Rehabilitation Centers LTD

  • Physical Therapist
  • Westmont, IL
  • NPI 1205875713
  NPD (past)
• Rebound Physical Therapy Center PC

  • Clinic/Center
  • Rockford, IL
  • NPI 1710099270

  Physical Therapist

  NPD (past)
• Sports Physical Therapy & Rehab Specialists, S.C.

  dba Athletico Physical Therapy

  • Physical Therapist
  • Kenosha, WI
  • NPI 1326150624
  NPD (past)
• Sports Physical Therapy & Rehabilitation Specialists S.C.

  dba Athletico Physical Therapy

  • Clinic/Center
  • Mukwonago, WI
  • NPI 1174187975

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1407964984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N5241 US HWY 45",
            "city": "WATERSMEET",
            "state": "MI",
            "postal_code": "499690009",
            "telephone_number": "063-584-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N5241 US HWY",
            "city": "WATERSMEET",
            "state": "MI",
            "postal_code": "499694996",
            "telephone_number": "906-358-4588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3616 N Main St",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611032159",
            "country_code": "US",
            "telephone_number": "815-877-5932",
            "fax_number": "815-877-6302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUNZE",
        "first_name": "LUCAS",
        "middle_name": "A",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-26",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018634",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10301024",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "P00214353",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "K22207",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0604410001",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40447500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Hansen, DC
• Jessica Anne Hoffman, FNP
• Kim Ivey, RPH
• Charissa Ann Jeske-Mahler, LMSW
• Kevin Michael Johnson, FNP
• Lac Vieux Desert Band of Lake Superior Chippewa Indians (LVD Health Center)
• Lac Vieux Desert Band of Lake Superior Chippewa Indians (Lac Vieux Desert Health Center and Pharmacy)
• Rebecca Larson, DDS
• Adrienne Laverdure, MD
• Nubqub Lee

• Physical Therapist in Watersmeet, MI
• Providers in Watersmeet, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.