Individual provider Active NPI

Olivia Rose Leroy

  • Physical Therapist
  • New York, NY
National Provider Identifier
1235951112
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05314801 Issued in NY
Practice address
535 E 70TH St
New York, NY 10021-4823
Phone
(212) 606-1000
NPI assigned
Oct 30, 2024
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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 40QA02264100 NJ
Physical Therapist 225100000X 05314801 NY Primary

Addresses

Primary practice location

535 E 70TH St
New York, NY 10021-4823

Mailing address

57 Glenmere Dr
Chatham, NJ 07928-1305
Phone (973) 699-5049

Other practice location 1

57 Glenmere Dr
Chatham, NJ 07928-1305
Phone (973) 699-5049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
40QA02264100NJMDPhysical Therapist
05314801NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1235951112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 GLENMERE DR",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079281305",
            "telephone_number": "973-699-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 E 70TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214823",
            "telephone_number": "212-606-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57 Glenmere Dr",
            "address_purpose": "LOCATION",
            "city": "Chatham",
            "state": "NJ",
            "postal_code": "079281305",
            "country_code": "US",
            "telephone_number": "973-699-5049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEROY",
        "first_name": "OLIVIA",
        "middle_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02264100",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "05314801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.