Individual provider Active NPI

David Wayne McLeary, MSPT

  • Physical Therapist
  • Ligonier, PA
National Provider Identifier
1720019227
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT000912E Issued in PA
Practice address
111 E Church St Ste B
Ligonier, PA 15658-1257
Phone
(724) 238-2099
Fax
(724) 238-2119
NPI assigned
Jul 5, 2006
Last updated
Aug 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT000912E PA Primary

Addresses

Primary practice location

111 E Church St Ste B
Ligonier, PA 15658-1257

Mailing address

3960 State Route 30
Suite 104
Latrobe, PA 15650-5518
Phone (724) 532-3422

Other identifiers 3

IdentifierTypeStateIssuer
0012785280003MedicaidPA
048476OtherPAHIGHMARK BC BS
0012785280002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031212000022 PA Practitioner - Physical Therapist in Private Practice 1355247016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weaver Physical Therapy, LLCGroup PAC ID 8022412238, 3 clinicians

Practice addresses (Care Compare)

111 E Church St B
In Sync Rehabilitation Services
Ligonier, PA 15658-1257
Phone (724) 238-2099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Weaver Physical Therapy, LLC Physical Therapist CurrentSince Aug 1, 2021 Accepting new patients
In-Sync Rehabilitation Services, Inc. Physical Therapist Past Accepting new patients

Locations

3960 State Route 30
Ste 104
Latrobe, PA 15650
Phone (724) 532-3422

111 E Church St
Ste B
Ligonier, PA 15658
Phone (724) 238-2099

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1720019227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 STATE ROUTE 30",
            "address_2": "SUITE 104",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156505518",
            "telephone_number": "724-532-3422",
            "fax_number": "724-532-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E CHURCH ST STE B",
            "city": "LIGONIER",
            "state": "PA",
            "postal_code": "156581257",
            "telephone_number": "724-238-2099",
            "fax_number": "724-238-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEARY",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT000912E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012785280003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC BS",
            "identifier": "048476",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012785280002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ligonier, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.