Dylan Leo, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02336900 Issued in NJ

Practice address

19 The Promenade SPC A3B
Edgewater, NJ 07020-2126

Phone

(201) 377-1510

Fax

(201) 377-2151

NPI assigned

May 28, 2025

Last updated

Jul 21, 2025By 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 NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edgewater Physical Therapy GroupGroup PAC ID 5991247942, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Edgewater Physical Therapy Group

  • Physical Therapist
  • Edgewater, NJ
  • NPI 1497515779
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1669265963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 THE PROMENADE SPC A3B",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070202126",
            "telephone_number": "201-377-1510",
            "fax_number": "201-377-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 THE PROMENADE SPC A3B",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070202126",
            "telephone_number": "201-377-1510",
            "fax_number": "201-377-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEO",
        "first_name": "DYLAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02336900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugene Seungkyu Lee, D.C.
• Jun Hee Lee, DC
• Sunghyuk Lee, DDS
• Timothy Hojoon Lee, DMD
• Brian Legg
• Alisha Lewis
• Tanya Leykin, M.D.
• Wei Wei Li, MD
• Daisy H Lignelli
• Tzu Yu Liu

• Physical Therapist in Edgewater, NJ
• Providers in Edgewater, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; 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.