Mai Yang Leichtle

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

9091 Issued in MN

Practice address

2350 Cleveland Ave N
Roseville, MN 55113-2701

Phone

(651) 757-0187

NPI assigned

Feb 6, 2022

Last updated

Oct 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Community Medical Services Montana Private LLC

  dba Community Medical Services-Minneapolis on Broadway

  • Methadone Clinic
  • Minneapolis, MN
  • NPI 1033804653
  NPD (past)
• Community Medical Services Montana-Private, LLC

  dba Community Medical Services

  • Methadone Clinic
  • Roseville, MN
  • NPI 1053069005
  NPD (past)

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

{
    "created_epoch": "1644105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1053065391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 PARKVIEW CT S",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551196916",
            "telephone_number": "651-757-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 CLEVELAND AVE N",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132701",
            "telephone_number": "651-757-0187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15251 Pleasant Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Center City",
            "state": "MN",
            "postal_code": "550129640",
            "country_code": "US",
            "telephone_number": "877-793-5205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEICHTLE",
        "first_name": "MAI",
        "middle_name": "YANG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-06",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "9091",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2040767",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Y Lee, D.O.
• Samantha Lee, PHARMD
• Sean Hyung-Kwon Lee, MD
• Andrew Legrid, LICSW
• Barbara Lehn
• Karen Elizabeth Leif, RN
• Charlotte Mary Leitschuh, RN, CNP
• Dawn Mary Lems
• Rachel Elizabeth Lenz, PA-C
• Jorge A Leon, MD

• Nurse Practitioner in Roseville, MN
• Providers in Roseville, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.