Individual provider Active NPI

Leah Jane Grinvalsky, DPT

  • Physical Therapist
  • Monroe, WI
National Provider Identifier
1386259885
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15190-24 Issued in WI
Practice address
516 26TH Ave
Monroe, WI 53566-1531
Phone
(608) 325-9141
NPI assigned
Sep 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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 15190-24 WI Primary

Addresses

Primary practice location

516 26TH Ave
Monroe, WI 53566-1531

Mailing address

516 26TH Ave
Monroe, WI 53566-1531
Phone (608) 325-9141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211102000493 WI Practitioner - Physical Therapist in Private Practice 2466840079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

5440 Caddis BND
Fitchburg, WI 53711-7105
Phone (800) 444-6845

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15190-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Physical Therapist CurrentSince Oct 11, 2021 Accepting new patients
Aegis Group Practice, LLC Physical Therapist CurrentSince Oct 11, 2021 Accepting new patients
Aegis Group Practice LLC Physical Therapist Current Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

111 Owen Rd
Monona, WI 53716
Phone (608) 441-9990

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": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1386259885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 26TH AVE",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535661531",
            "telephone_number": "608-325-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 26TH AVE",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535661531",
            "telephone_number": "608-325-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINVALSKY",
        "first_name": "LEAH",
        "middle_name": "JANE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "15190-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; 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.