Leonard R Disla, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

40QA01349800 Issued in NJ

Practice address

246 Industrial Way W
Eatontown, NJ 07724-4240

Phone

(732) 455-2724

NPI assigned

Oct 20, 2011

Sex

Male

Sole proprietor

No

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 NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• TSL Sport Therapeutics LLC

  • Physical Therapist
  • Manalapan, NJ
  • NPI 1861247066

  Orthopedic

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1962787085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 INDUSTRIAL WAY W",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077244240",
            "telephone_number": "732-455-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 INDUSTRIAL WAY W",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077244240",
            "telephone_number": "732-455-2724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISLA",
        "first_name": "LEONARD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-20",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "40QA01349800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Marie Dibello, PHARMD
• Taylor Digravina, PSYD
• Paul M Dilorenzo, M.D.
• Laura Ann Dimartino, LAC
• Marie Dimatteo, LPC
• Amanda Doerr
• Gordon D Donald III, MD
• Latsaha Capri Donaldson
• Melissa Lauren Dorsky, MSW
• Double Eagle Performance

• Orthopedic Physical Therapist in Eatontown, NJ
• Providers in Eatontown, NJ by specialty
• Orthopedic Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.