Leandro Modenese Bastos, PT DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

296037 Issued in CA

Practice address

12403 E 1St Ave
Spokane Valley, WA 99216-0702

Phone

(509) 370-7597

NPI assigned

Dec 17, 2018

Last updated

Mar 27, 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 WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sports Lab and Physical Therapy, PLLCGroup PAC ID 7810406766, 2 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.

• Sports Lab & Physical Therapy, PLLC

  dba Sports Lab

  • Physical Therapist
  • Spokane Valley, WA
  • NPI 1972295848
  Medicare reassignment Care Compare group NPD Authorized official
• Choice Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Temecula, CA
  • NPI 1770703266
  NPD (past)

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1679045546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 W ROSEWOOD AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992083740",
            "telephone_number": "562-212-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12403 E 1ST AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992160702",
            "telephone_number": "509-370-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTOS",
        "first_name": "LEANDRO",
        "middle_name": "MODENESE",
        "credential": "PT DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-17",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "296037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifier Marie Bartlett
• Belen Almudena Barton
• Jacqueline M Bassett, RN
• Michaela Mae Bassuer
• Jessica Lynn Bastine, RN
• Nina Bathurst, RN
• Mindi L Battin
• Nathan Bradley Bauder, MA, NCC, LMHCA
• Athena Farryn Bauer
• Abigail Elaine Baumann

• Physical Therapist in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.