Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Luke Isaac Boss

Individual provider Athletic Trainer · NPI 1770049595

Luke Isaac Boss is a Physical Therapist in Private Practice in Grand Rapids, Michigan. Qualified in 2023, 3 years ago. Practices as a sole proprietor. Licensed in Indiana and Michigan.

Years since qualifying
3
Licensed in
IN, MI
In the registry since
2019
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

5060 Cascade Rd SE Ste A
Grand Rapids, MI 49546-3808
Phone: (616) 954-0950
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 5501303207 (MI)
Athletic Trainer Taxonomy 2255A2300X · Licence 3630-29-3657 (IN)

Record details

NPI number1770049595
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 17, 2019
Last updated in NPPESFebruary 8, 2024
Certification dateFebruary 8, 2024
Mailing address5060 Cascade Rd Se Ste A, Grand Rapids, MI 49546-3808

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Grand Rapids