Leonard Merlin Galloway, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT20123 Issued in CA

Practice address

27620 Landau Blvd
Suite 3
Cathedral City, CA 92234-5540

Phone

(760) 322-5090

Fax

(760) 322-9175

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aegis Physical Therapy Inc. PSGroup PAC ID 6305921040, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aegis Physical Therapy Inc. PS

  • Physical Therapy Clinic/Center
  • Yakima, WA
  • NPI 1437330339
  Medicare reassignment Care Compare group NPD Authorized official
• Aegis Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Cathedral City, CA
  • NPI 1477753861

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1033149869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 KERN WAY",
            "address_2": "STE 102",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027804",
            "telephone_number": "760-322-5090",
            "fax_number": "760-322-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27620 LANDAU BLVD",
            "address_2": "SUITE 3",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922345540",
            "telephone_number": "760-322-5090",
            "fax_number": "760-322-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLOWAY",
        "first_name": "LEONARD",
        "middle_name": "MERLIN",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT20123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Cathedral City, CA
• Providers in Cathedral City, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.