Leah Marie Tibus

Individual provider Active NPI Physical Therapist · Wilkes Barre, PA

NPI 1811312903 · NPPES record last updated Apr 23, 2025

Key facts

NPI
1811312903
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT023389 (PA)
Practice address
40 W Northampton St
Wilkes Barre, PA 18701-1775
Phone
(570) 208-0466
NPI assigned
Feb 26, 2014
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160629000293 PA Practitioner - Physical Therapist in Private Practice 2365733904 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT023389PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wyoming Valley Childrens Association Physical Therapist Current
since Feb 27, 2025
Accepting new patients

Locations

1133 Wyoming Ave
Kingston, PA 18704
Phone (570) 714-1246

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT023389 PA Yes

Addresses

Primary practice location

40 W Northampton St
Wilkes Barre, PA 18701-1775

Mailing address

10 Hart PL
Carbondale, PA 18407-1593
Phone (570) 267-3959

Other practice location 1

1133 Wyoming Ave
Kingston, PA 18704-4003
Phone (570) 714-1246

Other providers in Wilkes Barre, PA

All providers in Wilkes Barre, PA · Physical Therapist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.