Leslie Blake Novoa, PT, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT60291158 Issued in WA

Practice address

4833 Tumwater Valley Dr SE Ste 150
Tumwater, WA 98501-4583

Phone

(360) 493-4160

Fax

(360) 419-3416

NPI assigned

Jul 11, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tahoma Physical Therapy PLLC

  • Physical Therapist
  • Olympia, WA
  • NPI 1093528879
  NPD Authorized official
• Providence Health & Services Washington

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1174744304
  Medicare reassignment
• Centralia Physical Therapy Inc PS

  • Physical Therapist
  • Centralia, WA
  • NPI 1952666315

  Orthopedic

  NPD
• Providence Health & Services Washington

  • Rehabilitation Clinic/Center
  • Tumwater, WA
  • NPI 1801989587
  NPD (past)

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1245595685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "360-486-6508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4833 TUMWATER VALLEY DR SE STE 150",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985014583",
            "telephone_number": "360-493-4160",
            "fax_number": "360-419-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOA",
        "first_name": "LESLIE",
        "middle_name": "BLAKE",
        "credential": "PT,  DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OR",
            "license": "6934",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WA",
            "license": "PT60291158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lnovoa512461@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2555 Marvin Rd NE",
            "city": "Lacey",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985163138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicole Alexandria Nomic
• Miriam Catherine Nordquist, RN
• Laura Kathryn Norell, RN, BSN
• Northwest Center for Sports Medicine & Physical Therapy Inc
• Anferny Victoria Novelo
• Lindsay Rae Nuxoll, CNA
• John Basinger O'Brien, PA-C
• Michael E O'Brien, MSPT
• Anthony O'Leary, LMHC
• Morgan Oconnor

• Orthopedic Physical Therapist in Tumwater, WA
• Providers in Tumwater, WA by specialty
• Orthopedic Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.