MR. RICHARD A. LIESKE (PT) – Physical Therapist, NPI 1265879688

MR. RICHARD A. LIESKE (PT) is a healthcare provider. based in Grand rapids, Michigan. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 5501008023 (MI). The NPI Number for MR. RICHARD A. LIESKE (PT) is 1265879688

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
MR. RICHARD A. LIESKE (PT)
NPI
1265879688
Phone
(616) 940-0660
Address
61 COMMERCE AVE SW
Enumeration Date
24 May 2013
Last Update Date
17 June 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9474794880
Graduation Year
1995 (31 years ago)
PAC ID
4183840010
Group Practice PAC ID
3678480290
Professional Enrollment ID
I20140729001557
Address ID
MI483093673RO2820XRDXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:13State licenses:1Digital endpointsOther names

3,459 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MI

Provider Addresses for MR. RICHARD A. LIESKE (PT)

  • 61 COMMERCE AVE SW

    GRAND RAPIDS, MI 49503

    Phone: (616) 940-0660

    Fax: (616) 940-1965

    Type: Mailing

  • 26850 PROVIDENCE PKWY

    SUITE 260

    NOVI, MI 48374

    Phone: (248) 735-8272

    Fax: (248) 735-7276

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-07-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140729001557IPhysical Therapist In Private PracticeMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49503)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3678480290View full group profile
NameSpecialtyState
Family PracticePA
Family PracticeMN
Orthopedic SurgeryPA
Orthopedic Surgery, Sports MedicinePA
Physical Therapist In Private PracticeMN
P O D I A T R YDE
-MN
Family PracticePA
-PA
Family PracticeMN

Reviews

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Frequently asked questions

What is the standard ID for MR. RICHARD A. LIESKE (PT) in the U.S.?
In the U.S., MR. RICHARD A. LIESKE (PT) is identified by NPI 1265879688.
Should I treat MR. RICHARD A. LIESKE (PT) as an active provider?
Patients and plans typically see MR. RICHARD A. LIESKE (PT) as active in the national extract.
Which specialty label fits MR. RICHARD A. LIESKE (PT)?
NPPES ties MR. RICHARD A. LIESKE (PT) to Physical Therapist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to MR. RICHARD A. LIESKE (PT)?
The directory associates MR. RICHARD A. LIESKE (PT) with Grand Rapids, Michigan. Check all listed addresses for suites or satellite offices.
Who maintains MR. RICHARD A. LIESKE (PT)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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