Luke T Mallory, DPT is a medicare enrolled "Physical Medicine & Rehabilitation" physician in Rathdrum, Idaho. His current practice location is
16658 N Highway 41, Rathdrum, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 687-9195.
Luke T Mallory is licensed to practice in Idaho (license number PT-8974) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1417712589.
Physician's Profile
| Full Name | Luke T Mallory |
|---|
| Gender | Male |
|---|
| Speciality | Physical Medicine & Rehabilitation |
|---|
| Location | 16658 N Highway 41, Rathdrum, Idaho |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1417712589
- Provider Enumeration Date: 02/19/2024
- Last Update Date: 02/27/2024
Medicare PECOS Information:
- PECOS PAC ID: 4486099256
- Enrollment ID: I20240302000247
Medical Identifiers
Medical identifiers for Luke T Mallory such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1417712589 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208100000X | Physical Medicine & Rehabilitation | PT-8974 (Idaho) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Luke T Mallory allows following entities to bill medicare on his behalf.
| Entity Name | Lakeland Physical Therapy And Sports Injuries P.a. |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1083896674
PECOS PAC ID: 9537158787
Enrollment ID: O20040511001525 |
|---|
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Luke T Mallory is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Luke T Mallory, DPT
16658 N Highway 41,
Rathdrum, ID 83858-6890
Ph: (208) 687-9195 | Luke T Mallory, DPT
16658 N Highway 41,
Rathdrum, ID 83858-6890
Ph: (208) 687-9195 |
Reviews and Comments