Individual provider Active NPI

Linda Mary Van Leeuwen, DPT

  • Physical Therapist
  • Wayne, NJ
National Provider Identifier
1780930941
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01450500 Issued in NJ
Practice address
44 Brighton Ter
Wayne, NJ 07470-6469
Phone
(973) 248-7314
NPI assigned
Jul 25, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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 40QA01450500 NJ Primary

Addresses

Primary practice location

44 Brighton Ter
Wayne, NJ 07470-6469

Mailing address

44 Brighton Ter
Wayne, NJ 07470-6469
Phone (973) 248-7314

Other practice location 1

700C Lake St
Ramsey, NJ 07446-1372
Phone (201) 962-7454

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230119001160 NJ Practitioner - Physical Therapist in Private Practice 8729235304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23 Yorktown Rd
Wayne, NJ 07470-3250
Phone (973) 248-7314

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01450500NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stride Physical Therapy & Wellness Physical Therapist CurrentSince Dec 6, 2022 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": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1780930941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 BRIGHTON TER",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074706469",
            "telephone_number": "973-248-7314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 BRIGHTON TER",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074706469",
            "telephone_number": "973-248-7314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700C Lake St",
            "address_purpose": "LOCATION",
            "city": "Ramsey",
            "state": "NJ",
            "postal_code": "074461372",
            "country_code": "US",
            "telephone_number": "201-962-7454",
            "fax_number": "201-962-7455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN LEEUWEN",
        "first_name": "LINDA",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01450500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.