Individual provider Active NPI

Matthew Lusk

  • Physical Therapist
  • Tacoma, WA
National Provider Identifier
1770255440
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
11112 Pacific Ave S
Tacoma, WA 98444-5749
Phone
(253) 537-1103
NPI assigned
Oct 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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 Primary

Addresses

Primary practice location

11112 Pacific Ave S
Tacoma, WA 98444-5749

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211013002893 WA Practitioner - Physical Therapist in Private Practice 6709284268 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Dec 10, 2024 Accepting new patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Sep 14, 2021 Accepting new patients
Multicare Health System CurrentSince Dec 10, 2024 Accepting new patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Sep 14, 2021 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist Current Accepting new patients
Highline Physical Therapy Group Physical Therapist CurrentSince Jul 18, 2023 Accepting new patients
Bonney Lake Physical Therapy and Hand Rehab, PLLC Physical Therapist CurrentSince Dec 19, 2022 Accepting new patients
Highline Physical Therapy Group Physical Therapist CurrentSince Jul 18, 2023 Accepting new patients
Multicare Health System Physical Therapist Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

20910 State Route 410 E
Bonney Lake, WA 98391
Phone (253) 862-2575

16259 Sylvester Rd SW
Burien, WA 98166
Phone (206) 241-5400

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

1010 S 336th St
Ste 112
Federal Way, WA 98003
Phone (253) 661-0041

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

9521 Gravelly Lake Dr SW
Lakewood, WA 98499
Phone (253) 983-9395

451 SW Sedgwick Rd
Ste 310
Port Orchard, WA 98367
Phone (360) 874-8009

11112 Pacific Ave S
Tacoma, WA 98444
Phone (253) 537-1103

Organizations & group practices 9

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": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1770255440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11112 PACIFIC AVE S",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984445749",
            "telephone_number": "253-537-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSK",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-01",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.