Individual provider Active NPI

Monica Rae Lesslie, DPT

  • Physical Therapist
  • Westlake Village, CA
National Provider Identifier
1104144674
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
36557 Issued in CA
Practice address
1800 Bridgegate St Ste 105
Westlake Village, CA 91361-1454
Phone
(315) 246-5791
NPI assigned
May 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 36557 CA Primary
Physical Therapist 225100000X 031019 NY

Addresses

Primary practice location

1800 Bridgegate St Ste 105
Westlake Village, CA 91361-1454

Mailing address

1800 Bridgegate St Ste 105
Westlake Village, CA 91361-1454
Phone (315) 246-5791

Other practice location 1

325 Rolling Oaks Dr Ste 210
Thousand Oaks, CA 91361-1088
Phone (805) 446-3141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180409002060 CA Practitioner - Physical Therapist in Private Practice 8820240187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Custom PT a Physical Therapy CorpGroup PAC ID 4981632551, 3 clinicians

Practice addresses (Care Compare)

325 Rolling Oaks Dr
Suite 210
Thousand Oaks, CA 91361-1088
Phone (805) 446-3141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36557CAMDClinical Social Worker
031019NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Custom P.T., a Physical Therapy Corp Physical Therapist CurrentSince Jan 1, 2018 Accepting new patients

Locations

325 Rolling Oaks Dr
Ste 210
Thousand Oaks, CA 91361
Phone (805) 446-3141

Organizations & group practices 1

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": "1273363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1104144674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 BRIDGEGATE ST STE 105",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913611454",
            "telephone_number": "315-246-5791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 BRIDGEGATE ST STE 105",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913611454",
            "telephone_number": "315-246-5791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 Rolling Oaks Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Thousand Oaks",
            "state": "CA",
            "postal_code": "913611088",
            "country_code": "US",
            "telephone_number": "805-446-3141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LESSLIE",
        "first_name": "MONICA",
        "middle_name": "RAE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-09",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "36557",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031019",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.