Individual provider Active NPI

Andrea Leifer

  • Physical Therapist
  • New York, NY
National Provider Identifier
1770917445
Registry record updated Aug 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
036476 Issued in NY
Practice address
162 W 72ND St
4TH FL
New York, NY 10023-3300
Phone
(212) 362-3595
Fax
(212) 362-3587
NPI assigned
Aug 29, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2013

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 036476 NY Primary

Addresses

Primary practice location

162 W 72ND St
4TH FL
New York, NY 10023-3300

Mailing address

1536 3Rd Ave
5TH FL
New York, NY 10028-2167
Phone (212) 861-2630

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
036476NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physical Therapy and Wellness, PC Physical Therapist PastSince Sep 5, 2013 Accepting new patients

Organizations & group practices 1

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": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377820800000",
    "number": "1770917445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 3RD AVE",
            "address_2": "5TH FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100282167",
            "telephone_number": "212-861-2630",
            "fax_number": "212-861-2685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 W 72ND ST",
            "address_2": "4TH FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100233300",
            "telephone_number": "212-362-3595",
            "fax_number": "212-362-3587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIFER",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-29",
        "last_updated": "2013-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "036476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; 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.