Individual provider Active NPI

Lucas Jardin Glomb, DPT, OCS

  • Orthopedic Physical Therapist
  • Wheat Ridge, CO
National Provider Identifier
1629693494
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
16969 Issued in CO
Practice address
3916 Wadsworth Blvd
Wheat Ridge, CO 80033-4615
Phone
(720) 805-2303
Fax
(720) 573-6704
NPI assigned
Jun 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 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 16969 CO
Orthopedic Physical Therapist 2251X0800X 16969 CO Primary

Addresses

Primary practice location

3916 Wadsworth Blvd
Wheat Ridge, CO 80033-4615

Mailing address

3916 Wadsworth Blvd
Wheat Ridge, CO 80033-4615
Phone (720) 805-2303

Other practice location 1

19964 Hilltop Rd Ste B
Parker, CO 80134-7317
Phone (303) 840-4667

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200618000419 CO Practitioner - Physical Therapist in Private Practice 0749602829 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mend PLLCGroup PAC ID 4284945791, 11 clinicians

Practice addresses (Care Compare)

2760 29TH St
Suite 1B
Boulder, CO 80301-1221
Phone (720) 772-6780

Merit-based Incentive Payment System (MIPS)

Final score
96.68 of 100Reported as group
Quality
96.09
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Panorama Orthopedics & Spine Center, PC CurrentSince Jun 15, 2020 Accepting new patients
Mend PLLC Physical Therapist CurrentSince Nov 7, 2024 Accepting new patients
Panorama Orthopedics & Spine Center, PC CurrentSince Jun 15, 2020 Accepting new patients
Panorama Orthopedics and Spine Center PC Current Accepting new patients

Locations

2760 29th St
Ste 1B
Boulder, CO 80301
Phone (720) 772-6780

660 Golden Ridge Rd
Ste 250
Golden, CO 80401
Phone (303) 274-7321

489 N US Highway 287
Ste 202
Lafayette, CO 80026
Phone (720) 772-6780

19964 Hilltop Rd
Ste B
Parker, CO 80134
Phone (303) 840-4667

3916 Wadsworth Blvd
Wheat Ridge, CO 80033
Phone (720) 805-2302

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": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1629693494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 WADSWORTH BLVD",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334615",
            "telephone_number": "720-805-2303",
            "fax_number": "720-573-6704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3916 WADSWORTH BLVD",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334615",
            "telephone_number": "720-805-2303",
            "fax_number": "720-573-6704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19964 Hilltop Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801347317",
            "country_code": "US",
            "telephone_number": "303-840-4667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLOMB",
        "first_name": "LUCAS",
        "middle_name": "JARDIN",
        "credential": "DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-08",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "16969",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CO",
            "license": "16969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.