Individual provider Active NPI

David Bryan Leach, M.D

  • Ophthalmology Physician
  • Moscow, ID
National Provider Identifier
1043379944
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
M8044 Issued in ID
Practice address
2500 W a St
Suite 202
Moscow, ID 83843-6000
Phone
(208) 882-4662
Fax
(208) 883-6557
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X M8044 ID Primary

Addresses

Primary practice location

2500 W a St
Suite 202
Moscow, ID 83843-6000

Mailing address

2500 W a St
Suite 202
Moscow, ID 83843-6000
Phone (208) 882-4662

Other identifiers 1

IdentifierTypeStateIssuer
805779000MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050523000433 WA Practitioner - Ophthalmology 6406897222 Reassigns benefits to 1 organization
I20070920000435 ID Practitioner - Ophthalmology 6406897222 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Kentucky College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clearview Eye Clinic LTDGroup PAC ID 7416998232, 6 clinicians

Practice addresses (Care Compare)

2500 W a St
Suite 202
Moscow, ID 83843-6000
Phone (208) 882-4662

Merit-based Incentive Payment System (MIPS)

Final score
93.15 of 100Reported as group
Quality
94.34
Improvement activities
40
Cost
84.71

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery347
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M8044IDMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clearview Eye Clinic LTD Ophthalmology CurrentSince Nov 1, 2001 Accepting new patients
Clearview Surgery Center, LLC Ophthalmology CurrentSince May 28, 2015 Accepting new patients

Locations

2840 Juniper Dr
Lewiston, ID 83501
Phone (208) 746-4100

2840 Juniper Dr
Ste 201A
Lewiston, ID 83501

2500 W A St
Ste 202
Moscow, ID 83843
Phone (208) 746-5100

804 S Washington St
Ste B
Moscow, ID 83843
Phone (208) 882-4662

835 SE Bishop Blvd
Pullman, WA 99163
Phone (509) 332-2541

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299110400000",
    "number": "1043379944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W A ST",
            "address_2": "SUITE 202",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838436000",
            "telephone_number": "208-882-4662",
            "fax_number": "208-883-6557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W A ST",
            "address_2": "SUITE 202",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838436000",
            "telephone_number": "208-882-4662",
            "fax_number": "208-883-6557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "DAVID",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2011-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ID",
            "license": "M8044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805779000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moscow, ID

Sources for this page

Verify at the official NPI Registry.