Leslie Icaro, MT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT.0006164 Issued in CO

Practice address

4380 Harlan St Ste 202
Wheat Ridge, CO 80033-5137

Phone

(303) 472-0193

NPI assigned

Aug 16, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

State licenses

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1639845183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13150 WIDE ACRES RD",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804014143",
            "telephone_number": "303-472-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4380 HARLAN ST STE 202",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800335137",
            "telephone_number": "303-472-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICARO",
        "first_name": "LESLIE",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "MT.0006164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Wheatridge",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4380 Harlan St Ste 202",
            "city": "Wheat Ridge",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800335137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Oanh Jasmine Huynh, RPH
• Thanhtu T Huynh, MD
• Lindsay Hyland
• Khayla Iacino-Krichau
• Nicole Ianni
• Ruth Iervolino, RN
• Cecilia Iguchi
• Suellen E Ikenberry, NP
• Marleyna Augusteina Illig
• Independent Living Solutions Inc.

• Massage Therapist in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Massage Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.