Individual provider Active NPI

Dylan Lannon

  • Physical Therapist
  • Puyallup, WA
National Provider Identifier
1497402853
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
17710 Canyon Rd E Ste 300
Puyallup, WA 98375-2559
Phone
(253) 271-3076
NPI assigned
Mar 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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 IL
Physical Therapist 225100000X Primary

Addresses

Primary practice location

17710 Canyon Rd E Ste 300
Puyallup, WA 98375-2559

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Other practice location 1

1661 Worcester Rd Ste 105
Framingham, MA 01701-5405
Phone (508) 626-2600

Other practice location 2

5911 W Baseline Rd Ste 102
Laveen, AZ 85339-2811
Phone (480) 281-6103

Other practice location 3

1016 Paradise Rd
Swampscott, MA 01907-1352
Phone (781) 309-9007

Other practice location 4

3011 N Clark St
Chicago, IL 60657-5205
Phone (773) 661-0240

Other practice location 5

5393 S Calle Santa Cruz Ste 107
Tucson, AZ 85706-3556
Phone (520) 225-0129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, AZ, WA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220311001425 MA Practitioner - Physical Therapist in Private Practice 4183019029 Reassigns benefits to 1 organization
I20230124002714 AZ Practitioner - Physical Therapist in Private Practice 4183019029 Reassigns benefits to 1 organization
I20250619000559 WA Practitioner - Physical Therapist in Private Practice 4183019029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Rehabilitation of Western New England LLCGroup PAC ID 7911979950, 201 clinicians
Apple Physical Therapy LLCGroup PAC ID 7810892072, 285 clinicians
Ati Holdings of Arizona LLCGroup PAC ID 2466732862, 223 clinicians

Practice addresses (Care Compare)

1661 Worcester Rd
Suite 105
Framingham, MA 01701-5405
Phone (508) 626-2600

17710 Canyon Rd E
Suite 300
Puyallup, WA 98375-2559
Phone (253) 271-3076

5911 W Baseline Rd
Suite 102
Laveen, AZ 85339-2811
Phone (480) 281-6103

Merit-based Incentive Payment System (MIPS)

Final score
86.09 of 100Reported as group
Quality
89.13
Improvement activities
40
Cost
73.57

Merit-based Incentive Payment System (MIPS)

Final score
85.19 of 100Reported as group
Quality
86.04
Improvement activities
40
Cost
76.23

Merit-based Incentive Payment System (MIPS)

Final score
86.49 of 100Reported as group
Quality
90
Improvement activities
40
Cost
73.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Feb 14, 2022 Accepting new patients
Apple Physical Therapy LLC Physical Therapist CurrentSince May 29, 2025 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist CurrentSince May 29, 2025 Accepting new patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Jan 23, 2023 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Feb 14, 2022 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist Current Accepting new patients
Carl Gustafson LLC Physical Therapist Past Accepting new patients

Locations

1485 E Florence Blvd
Ste 105
Casa Grande, AZ 85122
Phone (520) 494-3058

380 N Estrella Pkwy
Ste A1
Goodyear, AZ 85338
Phone (480) 455-6266

5911 W Baseline Rd
Ste 102
Laveen, AZ 85339
Phone (480) 281-6103

9127 W Thunderbird Rd
Ste 101
Peoria, AZ 85381
Phone (623) 322-0654

11209 N Tatum Blvd
Ste B120
Phoenix, AZ 85028
Phone (602) 595-0204

7620 E Indian School Rd
Ste 104
Scottsdale, AZ 85251
Phone (623) 522-5190

1020 S Harrison Rd
Unit 120
Tucson, AZ 85748
Phone (520) 207-6288

5393 S Calle Santa Cruz
Ste 107
Tucson, AZ 85706
Phone (520) 225-0129

790 Remington Blvd
Bolingbrook, IL 60440

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

1661 Worcester Rd
Ste 105
Framingham, MA 01701
Phone (508) 626-2600

1016 Paradise Rd
Swampscott, MA 01907
Phone (781) 309-9007

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

21806 103rd Avenue Ct E
Ste 103
Graham, WA 98338
Phone (253) 847-3700

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

17710 Canyon Rd E
Ste 300
Puyallup, WA 98375
Phone (253) 271-3076

Organizations & group practices 7

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": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1497402853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17710 CANYON RD E STE 300",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983752559",
            "telephone_number": "253-271-3076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1661 Worcester Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Framingham",
            "state": "MA",
            "postal_code": "017015405",
            "country_code": "US",
            "telephone_number": "508-626-2600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5911 W Baseline Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Laveen",
            "state": "AZ",
            "postal_code": "853392811",
            "country_code": "US",
            "telephone_number": "480-281-6103",
            "fax_number": "623-267-2654",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1016 Paradise Rd",
            "address_purpose": "LOCATION",
            "city": "Swampscott",
            "state": "MA",
            "postal_code": "019071352",
            "country_code": "US",
            "telephone_number": "781-309-9007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3011 N Clark St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575205",
            "country_code": "US",
            "telephone_number": "773-661-0240",
            "fax_number": "773-289-1541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5393 S Calle Santa Cruz Ste 107",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857063556",
            "country_code": "US",
            "telephone_number": "520-225-0129",
            "fax_number": "520-244-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANNON",
        "first_name": "DYLAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-07",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.