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

Nicholas David Lacey, PT, DPT

Individual provider Physical Therapist · NPI 1639638984

Nicholas David Lacey, PT, DPT is a Physical Therapist in Private Practice in Arroyo Grande, California. Graduated from State University of New York at Stony Brook, School of Medicine in 2018, 8 years ago. Practices with Mdrs Spine and Sport Inc, a 182-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
8
Trained at
State University of New York at Stony Brook, School of Medicine
Licensed in
CA
In the registry since
2019
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1510 W Branch St
Arroyo Grande, CA 93420-1817
Phone: (805) 489-7912
Fax: (805) 489-9697
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2345 E 8th St, National City, CA 91950-2800 — (619) 323-2040

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 296330 (CA)

Record details

NPI number1639638984
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorYes
NPI enumeratedMarch 17, 2019
Last updated in NPPESMarch 11, 2024
Certification dateMarch 11, 2024
Mailing address408 Higuera St Ste 200, San Luis Obispo, CA 93401-6135

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolSTATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduated 2018 (8 years in practice)
Group practice Mdrs Spine And Sport Inc — 182 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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