Lakeside Physical Therapy and Wellness LLC
NPI 1689212136 · Physical Therapist · Conneaut Lake, PA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lakeside Physical Therapy and Wellness LLC is a Physical Therapist organization in Conneaut Lake, PA (NPI 1689212136).
Provider details
- NPI number
- 1689212136
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Mark Leonard, Owner(814) 573-1549
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2019-12-16
- Last updated
- 2019-12-16
- Certified
- 2019-12-16
Frequently asked questions
- What is Lakeside Physical Therapy and Wellness LLC's NPI number?
- Lakeside Physical Therapy and Wellness LLC's National Provider Identifier (NPI) is 1689212136, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lakeside Physical Therapy and Wellness LLC?
- Lakeside Physical Therapy and Wellness LLC is classified in the NPPES registry as Physical Therapist (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Lakeside Physical Therapy and Wellness LLC located?
- Lakeside Physical Therapy and Wellness LLC's practice location on file with NPPES is 12109 Iroquois Rd, Conneaut Lake, PA 16316-3341.
- What is Lakeside Physical Therapy and Wellness LLC's phone number?
- The practice phone number listed in the NPPES registry for Lakeside Physical Therapy and Wellness LLC is (814) 382-9405.
- Does Lakeside Physical Therapy and Wellness LLC accept Medicare?
- Lakeside Physical Therapy and Wellness LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lakeside Physical Therapy and Wellness LLC?
- The authorized official listed on Lakeside Physical Therapy and Wellness LLC's NPPES record is Mark Leonard, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lakeside Physical Therapy and Wellness LLC's NPI active?
- Yes — Lakeside Physical Therapy and Wellness LLC's NPI (1689212136) is active in the NPPES registry as of the last update on 2019-12-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.