Lacey Wise, PT
NPI 1154830677ActiveIndividual· Physical Therapist· Castle Rock, WA
Physical Therapist (PT) with Centralia Physical Therapy Inc Ps, practicing in Castle Rock, Washington. Medicare paid $5,155 for services to 29 patients in 2024.
Overview
| NPI | 1154830677 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT |
| Sole proprietor | No |
| NPI issued | Sep 27, 2017 |
| Last updated in NPPES | Mar 26, 2024 |
| Certified by provider | Mar 22, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | PT61342050 | WA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (WA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 29 |
|---|---|
| Services billed | 243 across 9 procedure codes |
| Paid by Medicare | $5,155 |
Education and affiliations
| Graduation year | 2017 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Centralia Physical Therapy Inc PsCentralia, WA · 20 clinicians
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