Individual provider Active NPI

Leah Boente, PT, DPT, CERT. MDT.

  • Physical Therapist
  • Springfield, IL
National Provider Identifier
1508874744
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
70009000 Issued in IL
Practice address
2201 W White Oaks Dr
Springfield, IL 62704-6498
Phone
(217) 546-3301
Fax
(217) 546-3302
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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 70009000 IL Primary

Addresses

Primary practice location

2201 W White Oaks Dr
Springfield, IL 62704-6498

Mailing address

2201 W White Oaks Dr
Springfield, IL 62704-6498
Phone (217) 546-3301

Other identifiers 1

IdentifierTypeStateIssuer
08432067OtherILBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070518000168 IL Practitioner - Physical Therapist in Private Practice 9234236688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Professionals LLCGroup PAC ID 2062519416, 7 clinicians

Practice addresses (Care Compare)

306 E Adams St
Springfield, IL 62701-1403
Phone (217) 546-3301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
70009000ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Professionals LLC Physical Therapist CurrentSince Mar 7, 2007 Accepting new patients

Locations

2921 Greenbriar Dr
Ste B2
Springfield, IL 62704
Phone (217) 546-3301

306 E Adams St
Springfield, IL 62701
Phone (217) 546-3301

2201 W White Oaks Dr
Springfield, IL 62704
Phone (217) 546-3301

Organizations & group practices 1

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1508874744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 W WHITE OAKS DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046498",
            "telephone_number": "217-546-3301",
            "fax_number": "217-546-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 W WHITE OAKS DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046498",
            "telephone_number": "217-546-3301",
            "fax_number": "217-546-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOENTE",
        "first_name": "LEAH",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT, CERT. MDT.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "70009000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "08432067",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.