Luke T Mallory, DPT - Medicare Physical Medicine & Rehabilitation in Rathdrum, ID

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.

Contact Information

Luke T Mallory, DPT
16658 N Highway 41,
Rathdrum, ID 83858-6890
(208) 687-9195
(208) 687-9750



Physician's Profile

Full NameLuke T Mallory
GenderMale
SpecialityPhysical Medicine & Rehabilitation
Location16658 N Highway 41, Rathdrum, Idaho
Accepts Medicare AssignmentsMedicare 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.
IdentifierTypeStateIssuer
1417712589NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208100000XPhysical 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 NameLakeland Physical Therapy And Sports Injuries P.a.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083896674
PECOS PAC ID: 9537158787
Enrollment ID: O20040511001525

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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 AddressPractice 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

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Physical Medicine & Rehabilitation Doctors in Rathdrum, ID


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