Individual provider Active NPI

Peyton Oz Leblanc, DPT

  • Physical Therapist
  • Marrero, LA
National Provider Identifier
1699548859
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11657 Issued in LA
Practice address
1151 Barataria Blvd Ste 4300
Marrero, LA 70072-3084
Phone
(504) 934-8140
Fax
(504) 934-8044
NPI assigned
Oct 31, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 29796 MD
Physical Therapist 225100000X 11657 LA Primary

Addresses

Primary practice location

1151 Barataria Blvd Ste 4300
Marrero, LA 70072-3084

Mailing address

1151 Barataria Blvd Ste 4300
Marrero, LA 70072-3084
Phone (504) 934-8140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240220000154 DC Practitioner - Physical Therapist in Private Practice 2567806466 Reassigns benefits to 1 organization
I20240927000494 LA Practitioner - Physical Therapist in Private Practice 2567806466 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

717 4TH St
Gretna, LA 70053-5927
Phone (504) 321-6628

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29796MDMDClinical Social Worker
11657LAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Jan 15, 2024 Accepting new patients
Leblanc Dizziness and Balance LLC Physical Therapist CurrentSince Aug 20, 2024 Accepting new patients
Culicchia Neurological Clinic, LLC CurrentSince Sep 13, 2024 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Jan 15, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

717 4th St
Gretna, LA 70053
Phone (504) 321-6628

1111 Medical Center Blvd
Ste S750
Marrero, LA 70072

1151 Barataria Blvd
Ste 4300
Marrero, LA 70072
Phone (504) 934-8140

6842 Race Track Rd
#B
Bowie, MD 20715
Phone (240) 544-0200

11271 New Hampshire Ave
Silver Spring, MD 20904
Phone (240) 485-1280

Organizations & group practices 4

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": "1698710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1699548859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 BARATARIA BLVD STE 4300",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723084",
            "telephone_number": "504-934-8140",
            "fax_number": "504-934-8044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 BARATARIA BLVD STE 4300",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723084",
            "telephone_number": "504-934-8140",
            "fax_number": "504-934-8044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "PEYTON",
        "middle_name": "OZ",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-31",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "29796",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "11657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; 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.