Individual provider Active NPI

Leslie Ann Bombaci, P.T.

  • Physical Therapist
  • Menomonee Falls, WI
National Provider Identifier
1013195361
Registry record updated Sep 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10646024 Issued in WI
Practice address
W178N9201 Water Tower PL
Menomonee Falls, WI 53051-8029
Phone
(262) 532-7240
NPI assigned
Feb 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10646024 WI Primary

Addresses

Primary practice location

W178N9201 Water Tower PL
Menomonee Falls, WI 53051-8029

Mailing address

W178N9201 Water Tower PL
Menomonee Falls, WI 53051-8029
Phone (262) 532-7240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090817000530 WI Practitioner - Physical Therapist in Private Practice 3779637384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

110 Lone Oak LN
Hartford, WI 53027-2600
Phone (262) 670-1800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10646024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. Physical Therapist Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Dec 12, 2015 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Current Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

110 Lone Oak Ln
Hartford, WI 53027
Phone (262) 670-1800

1701 Fond du Lac Ave
Kewaskum, WI 53040
Phone (262) 626-4616

W126N7338 Flint Dr
Ste 200
Menomonee Falls, WI 53051

W129N7055 Northfield Dr
Menomonee Falls, WI 53051
Phone (262) 251-5305

N91W15750 Falls Pkwy
Menomonee Falls, WI 53051
Phone (262) 532-1100

W178N9201 Water Tower Pl
Menomonee Fls, WI 53051
Phone (262) 251-8704

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1013195361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W178N9201 WATER TOWER PL",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530518029",
            "telephone_number": "262-532-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W178N9201 WATER TOWER PL",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530518029",
            "telephone_number": "262-532-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBACI",
        "first_name": "LESLIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-07",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10646024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonee Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.