Individual provider Active NPI

Jessica Leung

  • Physical Therapist
  • Thornton, CO
National Provider Identifier
1497388151
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0015813 Issued in CO
Practice address
9195 Grant St Ste 305
Thornton, CO 80229-4386
Phone
(720) 638-5474
Fax
(303) 955-0179
NPI assigned
Feb 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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 24773 MA
Physical Therapist 225100000X PTL.0015813 CO Primary

Addresses

Primary practice location

9195 Grant St Ste 305
Thornton, CO 80229-4386

Mailing address

9195 Grant St Ste 305
Thornton, CO 80229-4386
Phone (720) 638-5474

Other practice location 1

220 Sutton St
North Andover, MA 01845-1680
Phone (978) 682-7009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220131001842 CO Practitioner - Physical Therapist in Private Practice 1456753367
I20240927003063 MA Practitioner - Physical Therapist in Private Practice 1456753367 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0015813COMDPhysical Therapist
24773MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Restore Osteo of Colorado LLC Physical Therapist CurrentSince Jun 20, 2022 Accepting new patients
Bay State Physical Therapy of Randolph Inc CurrentSince Sep 20, 2024 Accepting new patients
Bay State Physical Therapy of Randolph Inc Physical Therapist CurrentSince Sep 20, 2024 Accepting new patients
Restore Osteo of Colorado LLC Physical Therapist CurrentSince Jun 20, 2022 Accepting new patients

Locations

400 Indiana St
Ste 280
Lakewood, CO 80401
Phone (303) 216-2661

9195 Grant St
Ste 305
Thornton, CO 80229
Phone (303) 216-2661

191 Blue Hills Pkwy
Milton, MA 02186
Phone (617) 696-1974

1343 Providence Hwy
Norwood, MA 02062
Phone (781) 702-1339

Organizations & group practices 5

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": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1497388151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9195 GRANT ST STE 305",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294386",
            "telephone_number": "720-638-5474",
            "fax_number": "303-955-0179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9195 GRANT ST STE 305",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294386",
            "telephone_number": "720-638-5474",
            "fax_number": "303-955-0179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Sutton St",
            "address_purpose": "LOCATION",
            "city": "North Andover",
            "state": "MA",
            "postal_code": "018451680",
            "country_code": "US",
            "telephone_number": "978-682-7009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "24773",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0015813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.