Individual provider Active NPI

Leo Marcayda, PT

  • Specialist
  • Hobart, IN
National Provider Identifier
1497965693
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
05003904A Issued in IN
Practice address
1230 S Colorado St
Hobart, IN 46342-5847
Phone
(219) 942-3051
Fax
(219) 947-3132
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 05003904A IN Primary

Addresses

Primary practice location

1230 S Colorado St
Hobart, IN 46342-5847

Mailing address

1230 S Colorado St
Hobart, IN 46342-5847
Phone (219) 942-3051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
05003904AINMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497965693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 S COLORADO ST",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463425847",
            "telephone_number": "219-942-3051",
            "fax_number": "219-947-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 S COLORADO ST",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463425847",
            "telephone_number": "219-942-3051",
            "fax_number": "219-947-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCAYDA",
        "first_name": "LEO",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "05003904A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hobart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.