Individual provider Active NPI

Leela Satyendra, PT

  • Physical Therapist
  • San Rafael, CA
National Provider Identifier
1033272893
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT23921 Issued in CA
Practice address
4050 Redwood Hwy Ste G
San Rafael, CA 94903-5149
Phone
(415) 479-7100
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 PT23921 CA Primary

Addresses

Primary practice location

4050 Redwood Hwy Ste G
San Rafael, CA 94903-5149

Mailing address

4050 Redwood Hwy Ste G
San Rafael, CA 94903-5149
Phone (415) 479-7100

Other practice location 1

99 Montecillo Rd
Mob2
San Rafael, CA 94903-3308
Phone (415) 444-4247

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141121000015 CA Practitioner - Physical Therapist in Private Practice 4981826237 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renew Physical Therapy PCGroup PAC ID 6406022078, 18 clinicians

Practice addresses (Care Compare)

1427 Grant Ave
Novato, CA 94945-3118
Phone (415) 895-1705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT23921CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Active Marin Physical Therapy Inc CurrentSince Jun 1, 2024 Accepting new patients
Renew Physical Therapy PC Physical Therapist CurrentSince May 19, 2019 Accepting new patients

Locations

421 Miller Ave
Mill Valley, CA 94941
Phone (415) 388-8166

1427 Grant Ave
Novato, CA 94945
Phone (415) 275-2377

460 Boulevard Way
Ste 2D
Piedmont, CA 94610
Phone (510) 922-8872

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1033272893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 REDWOOD HWY STE G",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949035149",
            "telephone_number": "415-479-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 REDWOOD HWY STE G",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949035149",
            "telephone_number": "415-479-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99 Montecillo Rd",
            "address_2": "MOB2",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949033308",
            "country_code": "US",
            "telephone_number": "415-444-4247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SATYENDRA",
        "first_name": "LEELA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT23921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.