Active NPI
Lisa Michelle Saxe, PT, MTC
- Physical Therapist
- Fort Wayne, IN
National Provider Identifier
1992897045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05007104A
- Practice address
- 9602 Coldwater Rd
Suite 102
Fort Wayne, IN 46825-2095 - Phone
- (260) 489-9887
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05007104A | IN | Primary |
Addresses
Primary practice location
9602 Coldwater Rd
Suite 102
Fort Wayne, IN 46825-2095
Mailing address
9602 Coldwater Rd
Suite 102
Fort Wayne, IN 46825-2095
Phone (260) 489-9887
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102072957 | Other | IN | DOL |
| 382617193732 | Other | IN | TRICARE |
| 000000300155 | Other | IN | ANTHEM |
| 200455240 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070830000724 | IN | Practitioner - Physical Therapist in Private Practice | 0042303497 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9602 Coldwater Rd
Suite 102
Fort Wayne, IN 46825-2095
Phone (260) 489-9887
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05007104A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mallers & Swoverland Orthopaedic Physical Therapy | Physical Therapist | Current | Accepting new patients |
| QHG of Fort Wayne Company, LLC | Physical Therapist | Past | Accepting new patients |
| Redimed Dekalb LLC | Physical Therapist | Past | Accepting new patients |
Locations
9602 Coldwater Rd
Ste 102
Fort Wayne, IN 46825
Phone (260) 489-9887
7611 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 436-8454
Organizations & group practices 3
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.
-
- Physical Therapist
- Fort Wayne, IN
- NPI 1700869732
IN, Physical Therapist
-
- Physical Therapist
- Fort Wayne, IN
- NPI 1508967266
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289174400000",
"number": "1992897045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9602 COLDWATER RD",
"address_2": "SUITE 102",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468252095",
"telephone_number": "260-489-9887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9602 COLDWATER RD",
"address_2": "SUITE 102",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468252095",
"telephone_number": "260-489-9887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAXE",
"first_name": "LISA",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "PT, MTC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2010-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05007104A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DOL",
"identifier": "102072957",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "382617193732",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000300155",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200455240",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; 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.