Active NPI
Peter M Leininger, PT
- Physical Therapist
- Kalamazoo, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501302534
- Practice address
- 5886 Venture Park Dr
Kalamazoo, MI 49009-1848 - Phone
- (269) 375-4737
- Fax
- (269) 375-4747
- NPI assigned
- Jan 25, 2006
- Last updated
- Oct 13, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501302534 | MI | Primary |
| Physical Therapist | 225100000X | PT012839L | PA |
Addresses
Primary practice location
5886 Venture Park Dr
Kalamazoo, MI 49009-1848
Mailing address
625 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-2395
Phone (616) 356-5000
Other practice location 1
239 Northern Blvd
South Abington Township, PA 18411-9302
Phone (570) 587-2142
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 579950 | Other | PA | HIGHMARK BLUE SHIELD |
| 01816976 | Medicaid | PA | |
| 824632 | Other | PA | FIRST PRIORITY HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopedic and Sports Medicine Center of Northern Indiana, Inc | Current | Accepting new patients | |
| Orthopedic and Sports Medicine Center of Northern Indiana Inc | Current | Accepting new patients | |
| ASC Surgical Ventures, LLC | Past | Accepting new patients |
Locations
1720 Fulton St
Elkhart, IN 46514
2310 California Rd
Elkhart, IN 46514
Phone (574) 264-0791
2310 California Rd
Ste A
Elkhart, IN 46514
Phone (574) 206-1401
1775 E Kercher Rd
Goshen, IN 46526
Phone (574) 533-0300
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.
-
dba Osmc
- Orthopaedic Surgery Physician
- Elkhart, IN
- NPI 1710085253
-
dba Osmc
- Durable Medical Equipment & Medical Supplies
- Granger, IN
- NPI 1962170357
-
dba OSMC Outpatient Surgery Center
- Ambulatory Surgical Clinic/Center
- Elkhart, IN
- NPI 1083715148
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697155200000",
"number": "1467422931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 KENMOOR AVE SE STE 100",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495462395",
"telephone_number": "616-356-5000",
"fax_number": "616-356-5001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5886 VENTURE PARK DR",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490091848",
"telephone_number": "269-375-4737",
"fax_number": "269-375-4747"
}
],
"practiceLocations": [
{
"address_1": "239 Northern Blvd",
"address_purpose": "LOCATION",
"city": "South Abington Township",
"state": "PA",
"postal_code": "184119302",
"country_code": "US",
"telephone_number": "570-587-2142",
"fax_number": "570-587-1978",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEININGER",
"first_name": "PETER",
"middle_name": "M",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-25",
"last_updated": "2023-10-13",
"certification_date": "2023-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501302534",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT012839L",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "579950",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01816976",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST PRIORITY HEALTH",
"identifier": "824632",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; 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.