Jacob Leberman, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501019620 Issued in MI

Practice address

10047 Crossroad CT SE Ste 150
Caledonia, MI 49316-7317

Phone

(616) 233-3597

NPI assigned

Jun 7, 2021

Last updated

Apr 13, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advent Rehabilitation, LLCGroup PAC ID 9537070545, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Advent Rehabilitation, LLC

  dba Advent Physical Therapy

  • Physical Therapist
  • Grand Rapids, MI
  • NPI 1780639658
  Medicare reassignment Care Compare group NPD
• Advent Rehabilitation, LLC

  dba Advent Physical Therapy

  • Physical Therapist
  • Grand Rapids, MI
  • NPI 1437923729
  NPD

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1548837875",
    "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": "10047 CROSSROAD CT SE STE 150",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493167317",
            "telephone_number": "616-233-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBERMAN",
        "first_name": "JACOB",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-07",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Lynn Langdon, OTR
• Grey R Larison, PH.D.
• Larson DBT Counseling Services PLLC
• Leanne Marie Lawrence, PHARMD
• Mindi Lawson
• Tyler Ledy, MD
• Fallon Lee, LMSW
• Kaycee Lee
• Amber Michelle Lenhart, PT,DPT,AT,ATC
• Katia E Littrell, CCC-SLP

• Physical Therapist in Caledonia, MI
• Providers in Caledonia, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.