Individual provider Active NPI

Leslie Saueressig Duran, MSPT

  • Physical Therapist
  • Poncha Springs, CO
National Provider Identifier
1619137908
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8036 Issued in CO
Practice address
217 Summitview LN
Poncha Springs, CO 81201-9254
Phone
(303) 759-4221
Fax
(303) 756-1656
NPI assigned
Jun 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 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 8036 CO Primary

Addresses

Primary practice location

217 Summitview LN
Poncha Springs, CO 81201-9254

Mailing address

PO Box 1348
Poncha Springs, CO 81242-1006
Phone (303) 249-9718

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140821001044 CO Practitioner - Physical Therapist in Private Practice 3577781277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

301 Oak St
Unit B
Salida, CO 81201-3340
Phone (303) 249-9718

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8036COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Fitness for Function, LLC Physical Therapist CurrentSince Jan 6, 2020 Accepting new patients

Locations

301 Oak St
Unit B
Salida, CO 81201
Phone (303) 249-9718

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": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1619137908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1348",
            "city": "PONCHA SPRINGS",
            "state": "CO",
            "postal_code": "812421006",
            "telephone_number": "303-249-9718",
            "fax_number": "855-937-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 SUMMITVIEW LN",
            "city": "PONCHA SPRINGS",
            "state": "CO",
            "postal_code": "812019254",
            "telephone_number": "303-759-4221",
            "fax_number": "303-756-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURAN",
        "first_name": "LESLIE",
        "middle_name": "SAUERESSIG",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "8036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poncha Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.