Individual provider Active NPI

Leen Hosam Alyacoub, M.B.B.S

  • Nephrology Physician
  • Hamilton, NJ
National Provider Identifier
1013538917
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA12487600 Issued in NJ
Practice address
2333 Whitehorse Mercerville Rd Ste 3
Hamilton, NJ 08619-1946
Phone
(609) 890-9111
NPI assigned
May 1, 2020
Reactivated
Jun 26, 2023
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 25MA12487600 NJ Primary

Addresses

Primary practice location

2333 Whitehorse Mercerville Rd Ste 3
Hamilton, NJ 08619-1946

Mailing address

22207 Cedar Dr Apt 22207
Lawrence Township, NJ 08648-1267
Phone (716) 994-5943

Other identifiers 1

IdentifierTypeStateIssuer
25MA12487600OtherNJNJ LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250401000954 NJ Practitioner - Nephrology 7416303284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Consultants in Kidney Diseases, PAGroup PAC ID 1456320696, 4 clinicians

Practice addresses (Care Compare)

1557 Kuser Rd
Hamilton, NJ 08619-1946
Phone (609) 890-9111

2333 Whitehorse Mercerville Rd
Suite 4
Mercerville, NJ 08619-1946
Phone (609) 890-9111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA12487600NJMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Consultants in Kidney Diseases PA Nephrology CurrentSince Apr 1, 2025 Accepting new patients

Locations

2333 Whitehorse Mercerville Rd
#3
Mercerville, NJ 08619

2333 Whthrs Mrcvl Rd
Ste 4
Trenton, NJ 08619

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1013538917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22207 CEDAR DR APT 22207",
            "city": "LAWRENCE TOWNSHIP",
            "state": "NJ",
            "postal_code": "086481267",
            "telephone_number": "716-994-5943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 WHITEHORSE MERCERVILLE RD STE 3",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086191946",
            "telephone_number": "609-890-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALYACOUB",
        "first_name": "LEEN",
        "middle_name": "HOSAM",
        "name_prefix": "Ms.",
        "credential": "M.B.B.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-01",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "deactivation_date": "2022-01-11",
        "reactivation_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA12487600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ LICENSE",
            "identifier": "25MA12487600",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, NJ

Sources for this page

Verify at the official NPI Registry.