Individual provider Active NPI

Nicholas Thomas Legacy, DPT

  • Physical Therapist
  • La Jolla, CA
National Provider Identifier
1538635339
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT027130 Issued in PA
Practice address
4225 Executive SQ Ste 1500
La Jolla, CA 92037-1487
Phone
(800) 585-1299
NPI assigned
Oct 18, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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 PT027130 PA Primary

Addresses

Primary practice location

4225 Executive SQ Ste 1500
La Jolla, CA 92037-1487

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251007000769 WA Practitioner - Physical Therapist in Private Practice 0244737328 Reassigns benefits to 1 organization
I20251229002909 PA Practitioner - Physical Therapist in Private Practice 0244737328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apple Physical Therapy LLCGroup PAC ID 7810892072, 285 clinicians

Practice addresses (Care Compare)

27237 172ND Ave SE
Suite 121
Covington, WA 98042-7352
Phone (253) 216-0468

297 Evans City Rd
Butler, PA 16001-2754
Phone (814) 229-2877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT027130PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Physical Therapy, LLC Physical Therapist CurrentSince Sep 15, 2025 Accepting new patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Sep 15, 2025 Accepting new patients
Bish & Legacy Physical Therapy and Canine Rehabilitation LLC Physical Therapist CurrentSince Jan 5, 2026 Accepting new patients

Locations

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

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

297 Evans City Rd
Butler, PA 16001
Phone (724) 283-8144

27237 172nd Ave SE
Ste 121
Covington, WA 98042
Phone (253) 216-0468

27237 172nd Ave SE
Ste 123
Covington, WA 98042
Phone (253) 216-0468

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

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

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1538635339",
    "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": "4225 EXECUTIVE SQ STE 1500",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371487",
            "telephone_number": "800-585-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGACY",
        "first_name": "NICHOLAS",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-18",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT027130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.