Active NPI
Thomas W Lizotte Jr., CPO
- Prosthetist
- Tacoma, WA
National Provider Identifier
1770775868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetist
- License
- PS00000355
- Practice address
- 1901 S Washington St
Tacoma, WA 98405-1015 - Phone
- (253) 761-9255
- Fax
- (253) 564-7747
- NPI assigned
- Aug 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | OI00000335 | WA | |
| Prosthetist | 224P00000X | PS00000355 | WA | Primary |
Addresses
Primary practice location
1901 S Washington St
Tacoma, WA 98405-1015
Mailing address
324 Summit Ave
Fircrest, WA 98466-7316
Phone (253) 761-9255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9036963 | Medicaid | WA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OI00000335 | WA | MD | Orthotist |
| PS00000355 | WA | MD | Prosthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lizotte P & O Associates LLC | Orthotist | Current | Accepting new patients |
| Lizotte P&O Associates LLC | Orthotist | Current | 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": "1187049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197244800000",
"number": "1770775868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "324 SUMMIT AVE",
"city": "FIRCREST",
"state": "WA",
"postal_code": "984667316",
"telephone_number": "253-761-9255",
"fax_number": "253-564-7747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 S WASHINGTON ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984051015",
"telephone_number": "253-761-9255",
"fax_number": "253-564-7747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIZOTTE",
"first_name": "THOMAS",
"middle_name": "W",
"name_suffix": "Jr.",
"credential": "CPO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-14",
"last_updated": "2007-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "WA",
"license": "OI00000335",
"primary": false
},
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": "WA",
"license": "PS00000355",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9036963",
"state": "WA"
}
],
"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 Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.