Shelly Lebenson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

623 Gibson Ave
Kingston, PA 18704-5319

Phone

(570) 817-0580

NPI assigned

Feb 1, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prime Physical Therapy LLCGroup PAC ID 7911394325, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Prime Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Drums, PA
  • NPI 1063167856

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1422748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1104216928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 SUGARLOAF HEIGHTS RD",
            "city": "DRUMS",
            "state": "PA",
            "postal_code": "182222910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 GIBSON AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045319",
            "telephone_number": "570-817-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBENSON",
        "first_name": "SHELLY",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-01",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PT024215",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Lafratte, PHARMD
• Marlee Ann Lambert, PA-C
• Lanny C. Pelliccia DPM
• Sharon Ann Laskowski, LCSW
• Holly Leandri-May, DMD
• Jessica Lee, PT, DPT
• Amanda Elizabeth Leonard, LCSW
• Joseph Francis Leonardi, D.C.
• Robert E. Lesniak Sr., D.D.S.
• Let's Be Honest Counseling, LLC

• Physical Therapist in Kingston, PA
• Providers in Kingston, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.