Individual provider Active NPI

Rebecca A. Leblanc, DPT

  • Physical Therapist
  • Issaquah, WA
National Provider Identifier
1255086484
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61643350 Issued in WA
Practice address
510 8TH Ave NE Ste 340
Issaquah, WA 98029-5449
Phone
(425) 313-3055
Fax
(425) 313-3051
NPI assigned
Feb 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 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 4856 NH
Physical Therapist 225100000X PT61643350 WA Primary

Addresses

Primary practice location

510 8TH Ave NE Ste 340
Issaquah, WA 98029-5449

Mailing address

522 Amherst St Ste 22
Nashua, NH 03063-1019
Phone (603) 880-0448

Other practice location 1

522 Amherst St Ste 22
Nashua, NH 03063-1019
Phone (603) 880-0448

Other practice location 2

1200 112th Ave NE Ste C260
Bellevue, WA 98004-3746
Phone (425) 313-3055

Other identifiers 1

IdentifierTypeStateIssuer
4856OtherNHALLIED HEALTH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250224002940 WA Practitioner - Physical Therapist in Private Practice 1557881356 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4856NHMDPhysical Therapist
PT61643350WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S CurrentSince Jan 14, 2025 Accepting new patients
Proliance Surgeons Inc., P.S. Physical Therapist CurrentSince Jan 14, 2025 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients

Locations

1200 112th Ave NE
Ste C260
Bellevue, WA 98004
Phone (425) 313-3055

510 8th Ave NE
Ste 340
Issaquah, WA 98029
Phone (425) 313-3051

510 8th Ave NE
Ste 320
Issaquah, WA 98029

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

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": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1255086484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 AMHERST ST STE 22",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030631019",
            "telephone_number": "603-880-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 340",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295449",
            "telephone_number": "425-313-3055",
            "fax_number": "425-313-3051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "522 Amherst St Ste 22",
            "address_purpose": "LOCATION",
            "city": "Nashua",
            "state": "NH",
            "postal_code": "030631019",
            "country_code": "US",
            "telephone_number": "603-880-0448",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 112th Ave NE Ste C260",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980043746",
            "country_code": "US",
            "telephone_number": "425-313-3055",
            "fax_number": "425-313-3051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "REBECCA",
        "middle_name": "A.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "4856",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61643350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIED HEALTH",
            "identifier": "4856",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.