Individual provider Active NPI

Pamela M Leacu, PT

  • Physical Therapist
  • Vernon, CT
National Provider Identifier
1932116597
Registry record updated Feb 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008106 Issued in CT
Practice address
435 Hartford Tpke
Suite U
Vernon, CT 06066-4852
Phone
(860) 870-8272
Fax
(860) 875-0804
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 17571 MA
Physical Therapist 225100000X 008106 CT Primary

Addresses

Primary practice location

435 Hartford Tpke
Suite U
Vernon, CT 06066-4852

Mailing address

435 Hartford Tpke
Suite U
Vernon, CT 06066-4852
Phone (860) 979-1611

Other names 1

  • Pamela Johnson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070713000600 CT Practitioner - Physical Therapist in Private Practice 1759385495 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Rehabilitation Services Limited PartnershipGroup PAC ID 8426428129, 49 clinicians

Practice addresses (Care Compare)

435 Hartford Tpke
Suite U
Vernon, CT 06066-4834
Phone (860) 870-8272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008106CTMDPhysical Therapist
17571MAMDPhysical Therapist
8106CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Services Limited Partnership Physical Therapist CurrentSince Dec 1, 2022 Accepting new patients

Locations

15 Morgan Farms Dr
Ste 3
South Windsor, CT 06074
Phone (860) 644-2006

230 Mountain Rd
Fl 2
Suffield, CT 06078
Phone (860) 668-9589

435 Hartford Tpke
Ste U
Vernon Rockville, CT 06066
Phone (860) 870-8272

Organizations & group practices 2

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1932116597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 HARTFORD TPKE",
            "address_2": "SUITE U",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664852",
            "telephone_number": "860-979-1611",
            "fax_number": "203-866-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 HARTFORD TPKE",
            "address_2": "SUITE U",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664852",
            "telephone_number": "860-870-8272",
            "fax_number": "860-875-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACU",
        "first_name": "PAMELA",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "17571",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "008106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "JOHNSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vernon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.