Individual provider Active NPI

Logan Les Leichtman, PT, DPT

  • Physical Therapist
  • Thompson, OH
National Provider Identifier
1922816222
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT021495 Issued in OH
Practice address
15994 Burrows Rd
Thompson, OH 44086-9736
Phone
(440) 313-7798
NPI assigned
Dec 19, 2024
Last updated
Dec 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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 PT021495 OH Primary

Addresses

Primary practice location

15994 Burrows Rd
Thompson, OH 44086-9736

Mailing address

15994 Burrows Rd
Thompson, OH 44086-9736
Phone (440) 313-7798

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250204001123 WA Practitioner - Physical Therapist in Private Practice 8628508876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

2727 Hollycroft St
Suite 310
Gig Harbor, WA 98335-1312
Phone (253) 514-6757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT021495OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Physical Therapist CurrentSince Jan 1, 2025 Accepting new patients
Multicare Health System CurrentSince Jan 1, 2025 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System Physical Therapist Past Accepting new patients

Locations

2727 Hollycroft St
Ste 310
Gig Harbor, WA 98335
Phone (253) 514-6757

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1734566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1922816222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15994 BURROWS RD",
            "city": "THOMPSON",
            "state": "OH",
            "postal_code": "440869736",
            "telephone_number": "440-313-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15994 BURROWS RD",
            "city": "THOMPSON",
            "state": "OH",
            "postal_code": "440869736",
            "telephone_number": "440-313-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEICHTMAN",
        "first_name": "LOGAN",
        "middle_name": "LES",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT021495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thompson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.