Individual provider Active NPI

Samuel Greenleaf, PT, DPT

  • Physical Therapist
  • Redlands, CA
National Provider Identifier
1629863733
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
306672 Issued in CA
Practice address
1752 E Lugonia Ave Ste 117-1089
Redlands, CA 92374-2730
Phone
(909) 557-0712
NPI assigned
Apr 10, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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 306672 CA Primary

Addresses

Primary practice location

1752 E Lugonia Ave Ste 117-1089
Redlands, CA 92374-2730

Mailing address

1752 E Lugonia Ave Ste 1171089
Redlands, CA 92374-2730
Phone (909) 557-0712

Other names 1

  • Samuel Hart Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250916001704 CA Practitioner - Physical Therapist in Private Practice 3476057274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Physical Therapy IncGroup PAC ID 0941236376, 5 clinicians

Practice addresses (Care Compare)

25864 Business Ctr Dr
Suite C
Redlands, CA 92374-4515
Phone (909) 796-7700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
306672CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Physical Therapy, Inc. Physical Therapist CurrentSince Aug 27, 2025 Accepting new patients

Locations

25864 Business Center Dr
Ste C
Redlands, CA 92374
Phone (909) 796-7700

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": "1744243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1629863733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1752 E LUGONIA AVE STE 1171089",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742730",
            "telephone_number": "909-557-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 E LUGONIA AVE STE 117-1089",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742730",
            "telephone_number": "909-557-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENLEAF",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-10",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "306672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMUEL",
            "last_name": "HART",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; 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.