Individual provider Active NPI

Leann Panconi

  • Physical Therapist
  • Edison, NJ
National Provider Identifier
1457083594
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02091500 Issued in NJ
Practice address
2035 Lincoln Hwy
Edison, NJ 08817-3351
Phone
(732) 702-1099
NPI assigned
Jun 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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 40QA02091500 NJ Primary

Addresses

Primary practice location

2035 Lincoln Hwy
Edison, NJ 08817-3351

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5859

Other practice location 1

28 S Main St
Allentown, NJ 08501-1684
Phone (732) 882-5573

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220709000483 NJ Practitioner - Physical Therapist in Private Practice 2860872769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Rutgers New Jersey Medical School, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Occupational and Physical Therapy, PLLCGroup PAC ID 3779873401, 497 clinicians

Practice addresses (Care Compare)

201 Durham Ave
South Plainfield, NJ 07080-2504
Phone (908) 205-8625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02091500NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Jun 3, 2022 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Jun 3, 2022 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients

Locations

2035 Lincoln Hwy
Ste 1040
Edison, NJ 08817
Phone (732) 702-1099

1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424

524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591

524 Williamstown Rd
Sicklerville, NJ 08081
Phone (856) 262-9564

201 Durham Ave
South Plainfield, NJ 07080
Phone (908) 205-8625

576 Broadhollow Rd
Melville, NY 11747

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": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1457083594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 LINCOLN HWY",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088173351",
            "telephone_number": "732-702-1099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28 S Main St",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "NJ",
            "postal_code": "085011684",
            "country_code": "US",
            "telephone_number": "732-882-5573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANCONI",
        "first_name": "LEANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02091500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.