Individual provider Active NPI

Kyle Leiser, DPT

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1790449957
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT028507 Issued in PA
Practice address
5436 Quentin St Apt 1
Philadelphia, PA 19128-2817
Phone
(267) 374-5530
NPI assigned
Oct 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 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 PT028507 PA Primary

Addresses

Primary practice location

5436 Quentin St Apt 1
Philadelphia, PA 19128-2817

Mailing address

5436 Quentin St Apt 1
Philadelphia, PA 19128-2817
Phone (267) 374-5530

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240321000431 PA Practitioner - Physical Therapist in Private Practice 6103263512 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT028507PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabclinics SPT, Inc. CurrentSince Feb 11, 2024 Accepting new patients
Rehabclinics (SPT), Inc. Physical Therapist Current Accepting new patients
Rehabclinics SPT, Inc. CurrentSince Feb 11, 2024 Accepting new patients

Locations

4275 County Line Rd
Ste 26
Chalfont, PA 18914
Phone (267) 952-8120

604 Commons Dr
Ste D3
Oxford, PA 19363
Phone (610) 932-3619

Organizations & group practices 3

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": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1790449957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5436 QUENTIN ST APT 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191282817",
            "telephone_number": "267-374-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5436 QUENTIN ST APT 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191282817",
            "telephone_number": "267-374-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEISER",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT028507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.