Stuart S Leicht, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD17098 Issued in TN

Practice address

2898 Boones Creek Rd Ste 105
Johnson City, TN 37615-4976

Phone

(423) 262-0112

NPI assigned

Sep 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

DermatologyAlso: Internal Medicine

Education

Emory University School of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stuart.leicht.1@21619.direct.athenahealth.com

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.

• East Tennessee Medical and Surgical Dermatology

  • Medical Specialty Clinic/Center
  • Johnson City, TN
  • NPI 1356975106
  Medicare reassignment Authorized official
• Medical Education Assistance Corporation

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1235180480

  Dermatology

  Medicare reassignment NPD

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

• Wellmont Health System

  • General Acute Care Hospital
  • Bristol, TN
  • NPI 1124058615
  Care Compare affiliation

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1013902907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2898 BOONES CREEK RD STE 105",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154976",
            "telephone_number": "423-262-0112",
            "fax_number": "423-433-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2898 BOONES CREEK RD STE 105",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154976",
            "telephone_number": "423-262-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEICHT",
        "first_name": "STUART",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "MD17098",
            "primary": true
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "TN",
            "license": "MD17098",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "TN",
            "license": "MD17098",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD17098",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Marie Lefevers, BS
• Jillian Leffew
• Legacy Home Care, LLC
• Legacy Vein Center PLLC
• Victoria Lynne Legg
• Leighton W Wood DDS, M.S., PC
• Dylan Leitnaker, OTR/L
• Leah Abbigail Leitnaker, MS, CF-SLP
• Peter Lemkin, O.D.
• Taryn Lentchner, COTA/L

• Dermatology Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Dermatology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.