Individual provider Active NPI

Leesa D Foley, NP

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1053657387
Registry record updated Sep 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71004272A Issued in IN
Practice address
1140 W Michigan St
Indianapolis, IN 46202-5209
Phone
(317) 274-1019
Fax
(317) 278-4418
NPI assigned
Dec 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71004272A IN Primary

Addresses

Primary practice location

1140 W Michigan St
Indianapolis, IN 46202-5209

Mailing address

1140 West Michigan Street
Ste 102 N
Indianapolis, IN 46202-4959

Other identifiers 1

IdentifierTypeStateIssuer
201141010MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130423000237 IN Practitioner - Nurse Practitioner 1951547793 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Care Associates, Inc Family CurrentSince Nov 17, 2014 Accepting new patients
Indiana University Past Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAFGBA/Endpoint/BAFGBA

Organizations & group practices 3

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": "1355356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505347200000",
    "number": "1053657387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 WEST MICHIGAN STREET",
            "address_2": "STE 102 N",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462024959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W MICHIGAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025209",
            "telephone_number": "317-274-1019",
            "fax_number": "317-278-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLEY",
        "first_name": "LEESA",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-13",
        "last_updated": "2017-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004272A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201141010",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.