Individual provider Active NPI

Caitlin Leonard, PTA

  • Physical Therapy Assistant
  • Somerville, MA
National Provider Identifier
1689118762
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
9228 Issued in MA
Practice address
5 Middlesex Ave
Somerville, MA 02145-1102
Phone
(617) 591-4600
NPI assigned
Dec 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 9228 MA Primary

Addresses

Primary practice location

5 Middlesex Ave
Somerville, MA 02145-1102

Mailing address

56 Farragut Ave
1
Somerville, MA 02144-1709
Phone (781) 354-8276

Other identifiers 1

IdentifierTypeStateIssuer
9228OtherMAPTA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9228MAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1689118762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 FARRAGUT AVE",
            "address_2": "1",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021441709",
            "telephone_number": "781-354-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MIDDLESEX AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021451102",
            "telephone_number": "617-591-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "CAITLIN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-08",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "9228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA LICENSE",
            "identifier": "9228",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.