Individual provider Active NPI

Robert Raymond Leichliter, D.C.

  • Chiropractor
  • Ebensburg, PA
National Provider Identifier
1164879516
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC011159 Issued in PA
Practice address
927 W High St
Suite 5
Ebensburg, PA 15931-1856
Phone
(814) 419-4057
NPI assigned
May 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC011159 PA Primary

Addresses

Primary practice location

927 W High St
Suite 5
Ebensburg, PA 15931-1856

Mailing address

927 W High St
Suite 5
Ebensburg, PA 15931-1856
Phone (814) 419-4057

Other identifiers 1

IdentifierTypeStateIssuer
103127650-0001MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160805001085 PA Practitioner - Chiropractic 4385938877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Chiropractic of Johnstown PCGroup PAC ID 6103194840, 3 clinicians

Practice addresses (Care Compare)

334 Budfield St
Suite 100
Johnstown, PA 15904-3345
Phone (814) 262-0400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC011159PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. R.J. Scanlan Chiropractic Clinic, P,C. Chiropractor CurrentSince Jun 16, 2016 Accepting new patients
Synergy Chiropractic of Johnstown PC Chiropractor CurrentSince Oct 25, 2021 Accepting new patients
Procare PT LP PastSince Oct 25, 2021 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1000 N Center St
Ebensburg, PA 15931
Phone (814) 419-8445

334 Budfield St
Ste 100
Johnstown, PA 15904
Phone (814) 262-0400

Organizations & group practices 4

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": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1164879516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 W HIGH ST",
            "address_2": "SUITE 5",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159311856",
            "telephone_number": "814-419-4057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 W HIGH ST",
            "address_2": "SUITE 5",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159311856",
            "telephone_number": "814-419-4057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEICHLITER",
        "first_name": "ROBERT",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-16",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC011159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103127650-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ebensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.