Individual provider Active NPI

Amy C Lukasiewicz, P.T.

  • Physical Therapist
  • Havertown, PA
National Provider Identifier
1619916285
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-006920L Issued in PA
Practice address
57 W Eagle Rd
Havertown, PA 19083-2234
Phone
(610) 789-9887
Fax
(610) 789-9883
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT-006920L PA Primary

Addresses

Primary practice location

57 W Eagle Rd
Havertown, PA 19083-2234

Mailing address

1641 Surrey LN
Havertown, PA 19083-2525
Phone (610) 449-5678

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040212000378 PA Practitioner - Physical Therapist in Private Practice 5890689566 Reassigns benefits to 1 organization
Practice locations: Havertown, PA; Merion Station, PA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-006920LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Founders Physical Therapy LLC Physical Therapist CurrentSince Feb 1, 2010 Accepting new patients
Pain Relief and Physical Therapy, Inc. Physical Therapist PastSince Apr 1, 1997 Accepting new patients
Bryn Mawr Sports Medicine and Rehabilitation Physical Therapist PastSince Feb 26, 1991 Accepting new patients
Lifecare Podiatry, P.C. Past Accepting new patients

Locations

101 S Bryn Mawr Ave
Ste 202
Bryn Mawr, PA 19010
Phone (610) 527-3300

101 S Bryn Mawr Ave
Ste 200
Bryn Mawr, PA 19010
Phone (610) 527-9500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12226/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619916285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 SURREY LN",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832525",
            "telephone_number": "610-449-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 W EAGLE RD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832234",
            "telephone_number": "610-789-9887",
            "fax_number": "610-789-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKASIEWICZ",
        "first_name": "AMY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT-006920L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.