Individual provider Active NPI

Peter M Leininger, PT

  • Physical Therapist
  • Kalamazoo, MI
National Provider Identifier
1467422931
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501302534 Issued in MI
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, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
579950OtherPAHIGHMARK BLUE SHIELD
01816976MedicaidPA
824632OtherPAFIRST PRIORITY HEALTH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250728001231 IN Practitioner - Physical Therapist in Private Practice 6204832207 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic and Sports Medicine Center of Northern Indiana, Inc CurrentSince Jun 30, 2025 Accepting new patients
Orthopedic and Sports Medicine Center of Northern Indiana Inc CurrentSince Jun 30, 2025 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.

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.

Verify at the official NPI Registry.