NPIMap

Organization Active NPI

Health Lab LLC

  • Physical Therapist
  • Wasilla, AK
National Provider Identifier
1568230910
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
HEALTH LAB LLC
Doing business as
Health Lab Physical Therapy and Fitness
Practice address
3562 E Teague Trail Cir
Wasilla, AK 99654-8779
Phone
(402) 658-5430
NPI assigned
Dec 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Authorized official

Name
Luke Matzen, PT, DPTNPI 1598391492
Title
Owner
Phone
(402) 658-5430

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

3562 E Teague Trail Cir
Wasilla, AK 99654-8779

Mailing address

PO Box 3185
Palmer, AK 99645-3185
Phone (402) 658-5430

Other names 1

  • Health Lab Physical Therapy and Fitness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240812003614 AK Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2961940705 Receives reassigned benefits from 6 practitioners
Practice locations: Palmer, AK

National Provider Directory

National Provider Directory

Locations

1633 S Industrial Way
Ste B
Palmer, AK 99645
Phone (907) 206-2603

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1568230910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3185",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996453185",
            "telephone_number": "402-658-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3562 E TEAGUE TRAIL CIR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548779",
            "telephone_number": "402-658-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-15",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "MATZEN",
        "authorized_official_first_name": "LUKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-658-5430",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Lab Physical Therapy and Fitness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.