Mark J Leonard, P.T., D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT021261 Issued in PA

Practice address

11018 Hwy 18
3
Conneaut Lake, PA 16316-3556

Phone

(814) 382-6570

NPI assigned

Jun 1, 2011

Last updated

Jun 1, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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 PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeside Physical Therapy and Wellness LLCGroup PAC ID 9638590722, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.49 of 100Reported as group

Quality

98.19

Improvement activities

40

Cost

70.71

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lakeside Physical Therapy and Wellness LLC

  • Physical Therapist
  • Conneaut Lake, PA
  • NPI 1689212136
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1033403621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11018 HWY 18",
            "address_2": "3",
            "city": "CONNEAUT LAKE",
            "state": "PA",
            "postal_code": "163163556",
            "telephone_number": "814-382-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11018 HWY 18",
            "address_2": "3",
            "city": "CONNEAUT LAKE",
            "state": "PA",
            "postal_code": "163163556",
            "telephone_number": "814-382-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT021261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Knox
• Casey Lynn Kusich, RD, LDN
• Lakeside Chiropractic PC
• Lakeside Physical Therapy and Wellness LLC
• Izabella Leguard, MPAS, PA-C
• Kimberly Nicole Litwin, PHARMD
• Candyce A. Lucian, D.O.
• Kaelyn R Mitchell, CRNP
• Trish Lynn Mook, LCSW
• Professional Counseling and Consulting Services Inc

• Physical Therapist in Conneaut Lake, PA
• Providers in Conneaut Lake, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.