Individual provider Active NPI

Scott Leaderman, DPT

  • Physical Therapist
  • Chamblee, GA
National Provider Identifier
1255886024
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT012485 Issued in GA
Practice address
5440 Peachtree Blvd
Chamblee, GA 30341-2255
Phone
(470) 719-0090
Fax
(470) 719-0091
NPI assigned
Aug 22, 2016
Last updated
Dec 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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 PT012485 GA Primary

Addresses

Primary practice location

5440 Peachtree Blvd
Chamblee, GA 30341-2255

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258
Phone (586) 350-2644

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210119002202 GA Practitioner - Physical Therapist in Private Practice 0446663199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Laureate Medical Group at Northside, LLCGroup PAC ID 2668458530, 75 clinicians

Practice addresses (Care Compare)

6135 Barfield Rd
Atlanta, GA 30328-4307
Phone (404) 256-8500

Merit-based Incentive Payment System (MIPS)

Final score
80.89 of 100Reported as group
Quality
76.16
Promoting interoperability
88
Improvement activities
40
Cost
70.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT012485GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Dec 23, 2021 Accepting new patients
Laureate Medical Group at Northside LLC CurrentSince Jul 11, 2022 Accepting new patients
Northside Cardiovascular Professional Services, LLC Past Accepting new patients

Locations

3400 Old Milton Pkwy
Ste 500
Alpharetta, GA 30005
Phone (678) 775-2284

5440 Peachtree Blvd
Chamblee, GA 30341
Phone (470) 719-0090

5440 Peachtree Blvd
Ste 2
Chamblee, GA 30341
Phone (470) 719-0090

975 Dawsonville Hwy
Ste 6
Gainesville, GA 30501
Phone (470) 768-8100

6135 Barfield Rd
Sandy Springs, GA 30328
Phone (404) 250-6691

6135 Barfield Rd
Ste 200
Sandy Springs, GA 30328
Phone (404) 256-8500

6600 Peachtree Dunwoody Rd
Bldg 600
Sandy Springs, GA 30328

33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1255886024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 PEACHTREE BLVD",
            "city": "CHAMBLEE",
            "state": "GA",
            "postal_code": "303412255",
            "telephone_number": "470-719-0090",
            "fax_number": "470-719-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEADERMAN",
        "first_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-22",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chamblee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.