Organization Active NPI

Revive Physical Therapy & Wellness LLC

  • Orthopedic Physical Therapist
  • Sharon, MA
National Provider Identifier
1407729494
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
REVIVE PHYSICAL THERAPY & WELLNESS LLC
Practice address
210 N Main St Unit 9
Sharon, MA 02067-1276
Phone
(781) 390-9819
Fax
(781) 512-6403
NPI assigned
Sep 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Authorized official

Name
Dr. Leeza Meteleva, PT, DPTNPI 1588216725
Title
Physical Therapist
Phone
(781) 879-0858

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X Primary

Addresses

Primary practice location

210 N Main St Unit 9
Sharon, MA 02067-1276

Mailing address

210 N Main St Unit 9
Sharon, MA 02067-1276
Phone (781) 390-9819

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251030003852 MA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9931698768 Receives reassigned benefits from 1 practitioner
Practice locations: Sharon, MA

National Provider Directory

National Provider Directory

Locations

210 N Main St
#9
Sharon, MA 02067

210 N Main St
Ste 9
Sharon, MA 02067
Phone (781) 390-9819

210 N Main St
Unit 9
Sharon, MA 02067
Phone (781) 390-9819

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1758758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1407729494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N MAIN ST UNIT 9",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "020671276",
            "telephone_number": "781-390-9819",
            "fax_number": "781-512-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N MAIN ST UNIT 9",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "020671276",
            "telephone_number": "781-390-9819",
            "fax_number": "781-512-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE PHYSICAL THERAPY & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "METELEVA",
        "authorized_official_first_name": "LEEZA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "781-879-0858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sharon, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.