Individual provider Active NPI

Lisa A. Hicks, PT

  • Physical Therapist
  • Studio City, CA
National Provider Identifier
1710163589
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11026 Issued in MA
Practice address
4301 Colfax Ave
#306
Studio City, CA 91604-2836
Phone
(860) 539-6045
NPI assigned
Jan 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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 11026 MA Primary

Addresses

Primary practice location

4301 Colfax Ave
#306
Studio City, CA 91604-2836

Mailing address

4301 Colfax Ave Apt 306
Studio City, CA 91604-2832
Phone (860) 539-6045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11026MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Friendly Health, Inc. PastSince Nov 26, 2023 Accepting new patients
Sung H. Chin Therapeutic Adhc Services, Inc. Physical Therapist PastSince Sep 3, 2012 Accepting new patients

Organizations & group practices 2

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": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1710163589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 COLFAX AVE APT 306",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042832",
            "telephone_number": "860-539-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 COLFAX AVE",
            "address_2": "#306",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042836",
            "telephone_number": "860-539-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "LISA",
        "middle_name": "A.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-11",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "11026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Studio City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.