Individual provider Active NPI

Leah M Vereschagin, MSPT

  • Physical Therapist
  • Florida, NY
National Provider Identifier
1205902012
Registry record updated Jun 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
031094-01 Issued in NY
Practice address
15 Esther LN
Florida, NY 10921-1634
Phone
(973) 886-3349
NPI assigned
Nov 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2025

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 61304332401 UT
Physical Therapist 225100000X 031094-01 NY Primary

Addresses

Primary practice location

15 Esther LN
Florida, NY 10921-1634

Mailing address

15 Esther LN
Florida, NY 10921-1634
Phone (973) 886-3349

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131216000344 NY Practitioner - Physical Therapist in Private Practice 8729215942 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
031094-01NYMDPhysical Therapist
61304332401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PT and OT for Senior Rehab at Home PLLC Physical Therapist CurrentSince Jun 30, 2025 Accepting new patients

Locations

171 Kings Hwy
Brooklyn, NY 11223
Phone (877) 722-7700

8008 45th Ave
Ofc
Elmhurst, NY 11373

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751155200000",
    "number": "1205902012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ESTHER LN",
            "city": "FLORIDA",
            "state": "NY",
            "postal_code": "109211634",
            "telephone_number": "973-886-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ESTHER LN",
            "city": "FLORIDA",
            "state": "NY",
            "postal_code": "109211634",
            "telephone_number": "973-886-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERESCHAGIN",
        "first_name": "LEAH",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2025-06-29",
        "certification_date": "2025-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "61304332401",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031094-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florida, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.