Individual provider Active NPI

Luke Matzen, PT, DPT

  • Orthopedic Physical Therapist
  • Palmer, AK
National Provider Identifier
1598391492
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
183475 Issued in AK
Practice address
1633 S Industrial Way Ste B
Palmer, AK 99645-6713
Phone
(907) 260-2603
Fax
(844) 955-1845
NPI assigned
Mar 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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 4004 NE
Orthopedic Physical Therapist 2251X0800X 183475 AK Primary

Addresses

Primary practice location

1633 S Industrial Way Ste B
Palmer, AK 99645-6713

Mailing address

1355 Wright St
Blair, NE 68008-1267
Phone (402) 658-5430

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240827000789 AK Practitioner - Physical Therapist in Private Practice 9032521828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Lab LLCGroup PAC ID 2961940705, 6 clinicians

Practice addresses (Care Compare)

1633 S Industrial Way
Suite B
Palmer, AK 99645-6713
Phone (907) 206-2603

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4004NEMDPhysical Therapist
183475AKMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Health Lab LLC Physical Therapist CurrentSince Nov 17, 2023 Accepting new patients

Locations

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

Organizations & group practices 1

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": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1598391492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 WRIGHT ST",
            "city": "BLAIR",
            "state": "NE",
            "postal_code": "680081267",
            "telephone_number": "402-658-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 S INDUSTRIAL WAY STE B",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456713",
            "telephone_number": "907-260-2603",
            "fax_number": "844-955-1845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATZEN",
        "first_name": "LUKE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "4004",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AK",
            "license": "183475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.