Individual provider Active NPI

Luke W Chlastawa, DPT

  • Physical Therapist
  • Auburn, ME
National Provider Identifier
1447932868
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
690 Minot Ave Ste 2
Auburn, ME 04210-3922
Phone
(207) 753-3456
NPI assigned
Aug 4, 2023
Last updated
Aug 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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 ME Primary

Addresses

Primary practice location

690 Minot Ave Ste 2
Auburn, ME 04210-3922

Mailing address

16 Blue Spruce Farm Rd Apt 27
Westbrook, ME 04092-3937
Phone (413) 250-6041

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230922003777 ME Practitioner - Physical Therapist in Private Practice 3678927704 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Maine Medical Center CurrentSince Aug 14, 2023 Accepting new patients
Central Maine Medical Center CurrentSince Aug 14, 2023 Accepting new patients
Central Maine Medical Center Current Accepting new patients

Locations

690 Minot Ave
#2
Auburn, ME 04210
Phone (207) 753-3456

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1691107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1447932868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BLUE SPRUCE FARM RD APT 27",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923937",
            "telephone_number": "413-250-6041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 MINOT AVE STE 2",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042103922",
            "telephone_number": "207-753-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHLASTAWA",
        "first_name": "LUKE",
        "middle_name": "W",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-04",
        "last_updated": "2023-08-04",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.