LAKESIDE PHYSICAL THERAPY AND WELLNESS LLC
NPI 1689212136
Physical Therapist in Conneaut Lake, PA

Active since December 16, 2019
12109 IROQUOIS RD, CONNEAUT LAKE, PA 16316(814) 382-9405 Get Directions Write a Review

NPPES record last updated: December 16, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Lakeside Physical Therapy And Wellness Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKESIDE PHYSICAL THERAPY AND WELLNESS LLC (NPI 1689212136) is a healthcare organization registered as a physical therapist in Conneaut Lake, Pennsylvania and active in the NPI registry since December 2019. The organization lists Mark Leonard, Owner, as its authorized official.

NPPES Registry Identity

NPI1689212136
Entity TypeOrganization
Primary Taxonomy225100000X
Legal Business NameLAKESIDE PHYSICAL THERAPY AND WELLNESS LLC
Location Address12109 IROQUOIS RDConneaut Lake, PA 16316-3341
Mailing Address12109 Iroquois RdConneaut Lake, PA 16316-3341 · (814) 382-9405
Organization SubpartNo
Authorized OfficialMark LeonardOwner · (814) 573-1549
Enumeration DateDecember 16, 2019
✔ NPI 1689212136 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
12109 IROQUOIS RD, Conneaut Lake, PA 16316

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lakeside Physical Therapy And Wellness Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Lakeside Physical Therapy And Wellness LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Physical Therapist in Private Practice
NPI 1598694622
12109 IROQUOIS RD
Conneaut Lake, PA 16316
(814) 283-6570
Same address
Physical Therapist in Private Practice
NPI 1033403621
11018 HWY 18 3
Conneaut Lake, PA 16316
(814) 382-6570
✔ Accepts Medicare0.4 mi
Physical Therapist in Private Practice
NPI 1104198431
455 CHESTNUT ST
Meadville, PA 16335
(814) 547-6510
✔ Accepts Medicare7.7 mi
Physical Therapist in Private Practice
NPI 1396400750
115 E 11TH AVE
Conshohocken, PA 19428
(814) 573-4282
282 mi
Physical Therapist in Private Practice
NPI 1942387295
124 SW CHAMBER CT
Port St Lucie, FL 34986
(772) 288-2400
✔ Accepts Medicare986 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lakeside Physical Therapy And Wellness LLC's NPI number?

The NPI number for Lakeside Physical Therapy And Wellness LLC is 1689212136. It was assigned to this organization in the NPPES registry on December 16, 2019.

Where is Lakeside Physical Therapy And Wellness LLC located?

Lakeside Physical Therapy And Wellness LLC is located at 12109 Iroquois Rd, Conneaut Lake, PA 16316. The listed phone number is (814) 382-9405.

What is Lakeside Physical Therapy And Wellness LLC's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Lakeside Physical Therapy And Wellness LLC enrolled in Medicare?

Yes. Lakeside Physical Therapy And Wellness LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lakeside Physical Therapy And Wellness LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians, all in Physical Therapist in Private Practice, reassign their Medicare billing to Lakeside Physical Therapy And Wellness LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Lakeside Physical Therapy And Wellness LLC was last updated on December 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.