Active NPI
John R Leyendecker, MD
- Diagnostic Radiology Physician
- Dallas, TX
National Provider Identifier
1033193990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- L0377
- Practice address
- 5323 Harry Hines Blvd
Dallas, TX 75390-7201 - Phone
- (214) 648-7732
- NPI assigned
- Dec 5, 2005
- Last updated
- Jan 27, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | L0377 | TX | Primary |
Addresses
Primary practice location
5323 Harry Hines Blvd
Dallas, TX 75390-7201
Mailing address
PO Box 845347
Dallas, TX 75284-5347
Phone (214) 648-7732
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810000631 | Medicaid | WV | |
| 891361K | Medicaid | NC | |
| D5072 | Other | NC | MEDCOST |
| 804390 | Other | NC | PARTNERS |
| Q0054J | Medicaid | SC | |
| 1361K | Other | NC | BCBS |
| 7801123 | Other | AETNA | |
| 10080754 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 82.87 of 100
- Quality
- 70.15
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.75
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422316800000",
"number": "1033193990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 845347",
"city": "DALLAS",
"state": "TX",
"postal_code": "752845347",
"telephone_number": "214-648-7732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5323 HARRY HINES BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "753907201",
"telephone_number": "214-648-7732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEYENDECKER",
"first_name": "JOHN",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-05",
"last_updated": "2015-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TX",
"license": "L0377",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810000631",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891361K",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "D5072",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "804390",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q0054J",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1361K",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7801123",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10080754",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2015; 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.