Jackie Lau

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

65082 Issued in OR

Practice address

801 W Ann Arbor TRL Ste 220
Plymouth, MI 48170-6224

Phone

(866) 991-0900

Fax

(866) 992-0900

NPI assigned

Feb 2, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oregon Luna Care Physical Therapy LLCGroup PAC ID 5597178087, 51 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Oregon Luna Care Physical Therapy LLC

  • Physical Therapist
  • Hillsboro, OR
  • NPI 1891397121
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1942063896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W ANN ARBOR TRL STE 220",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706224",
            "telephone_number": "866-991-0900",
            "fax_number": "866-992-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W ANN ARBOR TRL STE 220",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706224",
            "telephone_number": "866-991-0900",
            "fax_number": "866-992-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAU",
        "first_name": "JACKIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "65082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alec Lara
• Jaiden Lara
• Kelsey Elise Larios, CRNA
• Hannah Lash, LLP
• Lutfi Lasida
• Tammy Laughner
• Anna Laughrige
• Jennifer Ranee Lauria, PSYSP, LLP
• Madalynn Lauscher
• Sean Lavelle

• Physical Therapist in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.