Individual provider Active NPI

Leah Brooke Pambianco, DPT

  • Physical Therapist
  • Berwick, PA
National Provider Identifier
1740648633
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT025020 Issued in PA
Practice address
1222 W Front St
Berwick, PA 18603-4402
Phone
(570) 752-7762
NPI assigned
Feb 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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 PT025020 PA Primary

Addresses

Primary practice location

1222 W Front St
Berwick, PA 18603-4402

Mailing address

17 Stoneledge LN
Sweet Valley, PA 18656-2542
Phone (570) 574-6306

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160315000135 PA Practitioner - Physical Therapist in Private Practice 7719283977 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Derek Enterprises LLCGroup PAC ID 1355791252, 4 clinicians
Steffie Enterprises, IncGroup PAC ID 0840225736, 38 clinicians

Practice addresses (Care Compare)

106 Rotary Dr
West Hazleton, PA 18202-1182
Phone (570) 459-6333

1222 W Front St
Berwick, PA 18603-4402
Phone (570) 752-7762

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT025020PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Steffie Enterprises, Inc Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients
Dylan RC Enterprises Inc Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients
Derek Enterprises LLC Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients
Alycam Inc Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients

Locations

1222 W Front St
Berwick, PA 18603
Phone (570) 752-7762

1150 Old Berwick Rd
Bloomsburg, PA 17815
Phone (570) 784-2002

87 Oxford St
Hanover Township, PA 18706
Phone (570) 387-2202

693 Main St
New Milford, PA 18834
Phone (570) 465-2027

106 Rotary Dr
West Hazleton, PA 18202
Phone (570) 455-2286

1086 Highway 315 Blvd
Wilkes Barre, PA 18702
Phone (570) 823-7761

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": "1454630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1740648633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 STONELEDGE LN",
            "city": "SWEET VALLEY",
            "state": "PA",
            "postal_code": "186562542",
            "telephone_number": "570-574-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 W FRONT ST",
            "city": "BERWICK",
            "state": "PA",
            "postal_code": "186034402",
            "telephone_number": "570-752-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAMBIANCO",
        "first_name": "LEAH",
        "middle_name": "BROOKE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-05",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT025020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwick, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.