Individual provider Active NPI

Myles Luster, PTA

  • Physical Therapy Assistant
  • Lakeland, FL
National Provider Identifier
1861288870
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
33993 Issued in FL
Practice address
1826 N Crystal Lake Dr
Lakeland, FL 33801-5905
Phone
(813) 876-8771
NPI assigned
Apr 16, 2025
Last updated
Apr 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 33993 FL Primary

Addresses

Primary practice location

1826 N Crystal Lake Dr
Lakeland, FL 33801-5905

Mailing address

1826 N Crystal Lake Dr
Lakeland, FL 33801-5905
Phone (813) 876-8771

Other practice location 1

1129 Professional Park Dr
Brandon, FL 33511-4887
Phone (813) 876-8771

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

LicenseStateTypeSpecialty
33993FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pribila Consulting Services Inc CurrentSince Oct 8, 2010 Accepting new patients

Locations

1129 Professional Park Dr
Brandon, FL 33511
Phone (813) 876-8771

1826 N Crystal Lake Dr
Lakeland, FL 33801
Phone (813) 876-8771

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1861288870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1826 N CRYSTAL LAKE DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015905",
            "telephone_number": "813-876-8771",
            "fax_number": "813-333-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 N CRYSTAL LAKE DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015905",
            "telephone_number": "813-876-8771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1129 Professional Park Dr",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335114887",
            "country_code": "US",
            "telephone_number": "813-876-8771",
            "fax_number": "813-333-5414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUSTER",
        "first_name": "MYLES",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "33993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.