Individual provider Active NPI

Juan Rodrigo Leija Jr.

  • Physical Therapist
  • San Antonio, TX
National Provider Identifier
1023537107
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1293079 Issued in TX
Practice address
11219 Potranco Rd Ste A110
San Antonio, TX 78253-5848
Phone
(210) 679-6900
Fax
(210) 679-6904
NPI assigned
Sep 11, 2017
Last updated
Jun 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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 1293079 TX Primary

Addresses

Primary practice location

11219 Potranco Rd Ste A110
San Antonio, TX 78253-5848

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

3233 W Charleston Blvd Ste 107
Las Vegas, NV 89102-1923
Phone (702) 258-9381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as group
Quality
85
Improvement activities
40
Cost
85.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1293079TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medicine Associates CurrentSince Nov 1, 2018 Accepting new patients
Physiosports Therapy, PLLC PastSince Sep 1, 2023 Accepting new patients

Locations

4647 Medical Dr
San Antonio, TX 78229
Phone (210) 358-2710

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1023537107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11219 POTRANCO RD STE A110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782535848",
            "telephone_number": "210-679-6900",
            "fax_number": "210-679-6904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3233 W Charleston Blvd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021923",
            "country_code": "US",
            "telephone_number": "702-258-9381",
            "fax_number": "702-258-9584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEIJA",
        "first_name": "JUAN",
        "middle_name": "RODRIGO",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-11",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1293079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.