Individual provider Active NPI

Dylan Leclair

  • Physical Therapist
  • Timonium, MD
National Provider Identifier
1174314900
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30429 Issued in MD
Practice address
10803 Falls Rd
Timonium, MD 21093-4518
Phone
(978) 424-5858
NPI assigned
May 13, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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 30429 MD Primary

Addresses

Primary practice location

10803 Falls Rd
Timonium, MD 21093-4518

Mailing address

12 Pheasant Ridge Rd
Townsend, MA 01469-1200

Other practice location 1

4924 Campbell Blvd Ste 130A
Nottingham, MD 21236-5909
Phone (443) 997-1663

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250702003658 MD Practitioner - Physical Therapist in Private Practice 4183137052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 E Eager St
E Baltimore Med Ctr
Baltimore, MD 21202-5533
Phone (410) 522-9800

10803 Falls Rd
Suite 2100
Lutherville, MD 21093-4562
Phone (410) 367-3307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30429MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians CurrentSince Jun 5, 2025 Accepting new patients
Johns Hopkins Community Physicians, Inc Physical Therapist CurrentSince Jun 5, 2025 Accepting new patients
Johns Hopkins Community Physicians, Inc Current Accepting new patients

Locations

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

4924 Campbell Blvd
Ste 130A
Nottingham, MD 21236
Phone (443) 442-2050

Organizations & group practices 3

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": "1747094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1174314900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 PHEASANT RIDGE RD",
            "city": "TOWNSEND",
            "state": "MA",
            "postal_code": "014691200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10803 FALLS RD",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210934518",
            "telephone_number": "978-424-5858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4924 Campbell Blvd Ste 130A",
            "address_purpose": "LOCATION",
            "city": "Nottingham",
            "state": "MD",
            "postal_code": "212365909",
            "country_code": "US",
            "telephone_number": "443-997-1663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LECLAIR",
        "first_name": "DYLAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Timonium, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.