Matthew Leyesa, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

30307 Issued in CA

Practice address

10518 Peach Tree LN
Rancho Cucamonga, CA 91737-2441

Phone

(909) 702-2045

NPI assigned

Mar 13, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Sand Coast Rehab Physical Therapy Inc

  • Physical Therapist
  • Lakewood, NJ
  • NPI 1639766603

  CA, Speech-Language Pathologist

  Medicare reassignment NPD

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1790486165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10518 PEACH TREE LN",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917372441",
            "telephone_number": "909-702-2045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10518 PEACH TREE LN",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917372441",
            "telephone_number": "909-702-2045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEYESA",
        "first_name": "MATTHEW",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "30307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Rose Lewis
• Mercy Lewis
• Sydney Lewis
• Tricia Lee Lewis, SLP
• Maria Eloiza Leyesa
• Lgibson Anesthesia Inc
• Alexander Wang-Kee Li Jr., PHARMD
• Binwu Li
• Emily Li, DMD
• Megan Li

• Speech-Language Pathologist in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.