Individual provider Active NPI

Katie E Leiser, PT

  • Physical Therapist
  • Lebanon, NH
National Provider Identifier
1619140308
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3350 Issued in NH
Practice address
112 Etna Rd
Lebanon, NH 03766-1454
Phone
(603) 643-7788
Fax
(603) 643-0022
NPI assigned
Apr 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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 008176 CT
Physical Therapist 225100000X 3350 NH Primary

Addresses

Primary practice location

112 Etna Rd
Lebanon, NH 03766-1454

Mailing address

PO Box 727
Lebanon, NH 03766-0727
Phone (603) 643-7788

Other identifiers 2

IdentifierTypeStateIssuer
000685101OtherNHMEDICARE PTAN
3100041MedicaidNH

Other names 1

  • Katie E Janczak Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080919000133 NH Practitioner - Physical Therapist in Private Practice 9032286893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cioffredi and Associates Physical Therapy LLCGroup PAC ID 0648184655, 14 clinicians

Practice addresses (Care Compare)

112 Etna Rd
Lebanon, NH 03766-1454
Phone (603) 643-7788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
8176CTMDSocial Worker
3350NHMDPharmacist
008176CTMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cioffredi & Associates Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2008 Accepting new patients
Integrated Rehabilitation Services, LLC Physical Therapist PastSince Sep 15, 2014 Accepting new patients
Integrated Rehabilitation Services Limited Partnership Physical Therapist Past Accepting new patients
Sacred Heart University, Inc Physical Therapist Past Accepting new patients

Locations

112 Etna Rd
Lebanon, NH 03766
Phone (603) 643-7788

Organizations & group practices 4

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": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1619140308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 727",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037660727",
            "telephone_number": "603-643-7788",
            "fax_number": "603-643-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 ETNA RD",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661454",
            "telephone_number": "603-643-7788",
            "fax_number": "603-643-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEISER",
        "first_name": "KATIE",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "008176",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "3350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000685101",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3100041",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "JANCZAK",
            "middle_name": "E",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lebanon, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; 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.