Individual provider Active NPI

Leah Avery, PT

  • Physical Therapist
  • Oshkosh, WI
National Provider Identifier
1457028995
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05014335A Issued in IN
Practice address
631 Hazel St
Oshkosh, WI 54901-4600
Phone
(920) 252-4442
NPI assigned
Aug 24, 2021
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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 05014335A IN Primary

Addresses

Primary practice location

631 Hazel St
Oshkosh, WI 54901-4600

Mailing address

631 Hazel St
Oshkosh, WI 54901-4600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251114003587 WI Practitioner - Physical Therapist in Private Practice 2567867872 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oasis Therapy Services LLCGroup PAC ID 8325427974, 73 clinicians

Practice addresses (Care Compare)

631 Hazel St
Oshkosh, WI 54901-4600
Phone (920) 393-9998

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sundance Rehabilitation LLC Physical Therapist CurrentSince Sep 7, 2025 Accepting new patients
Oasis Therapy Services LLC Physical Therapist CurrentSince Nov 4, 2025 Accepting new patients
Powerback Rehab Current Accepting new patients

Locations

8170 McCormick Blvd
Ste 112
Skokie, IL 60076
Phone (920) 252-4442

6109 Braun Rd
Mount Pleasant, WI 53403
Phone (262) 484-4724

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": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1457028995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 HAZEL ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549014600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 HAZEL ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549014600",
            "telephone_number": "920-252-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "LEAH",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05014335A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; 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.