Individual provider Active NPI

Dallas A Lea, M.D.

  • Spinal Cord Injury Medicine Physician
  • Silver Spring, MD
National Provider Identifier
1063420750
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Spinal Cord Injury Medicine PhysicianTaxonomy code 2081P0004X
License
D59136 Issued in MD
Practice address
1400 Spring St
Suite 400
Silver Spring, MD 20910-2735
Phone
(301) 495-3742
Fax
(301) 495-3743
NPI assigned
Aug 4, 2006
Last updated
Apr 1, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Spinal Cord Injury Medicine Physician 2081P0004X D59136 MD Primary
Spinal Cord Injury Medicine Physician 2081P0004X MD33523 DC
Spinal Cord Injury Medicine Physician 2081P0004X L3375 TX

Addresses

Primary practice location

1400 Spring St
Suite 400
Silver Spring, MD 20910-2735

Mailing address

1400 Spring St
Suite 400
Silver Spring, MD 20910-2735
Phone (301) 495-3742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20061016000524 DC Practitioner - Physical Medicine and Rehabilitation 0143290775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Medical College of Ohio, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1400 Spring St
Suite 400
Silver Spring, MD 20910-2754
Phone (301) 495-3742

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD33523DCMDSpinal Cord Injury Medicine Physician
L3375TXMDSpinal Cord Injury Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lea Medical Partners, LLC CurrentSince Dec 1, 2013 Accepting new patients
Lea Medical Partners, LLC CurrentSince Oct 1, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
National Rehabilitation Hospital Inc Past Accepting new patients

Locations

1400 Spring St
Ste 400
Silver Spring, MD 20910
Phone (301) 364-9292

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427846400000",
    "number": "1063420750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SPRING ST",
            "address_2": "SUITE 400",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209102735",
            "telephone_number": "301-495-3742",
            "fax_number": "301-495-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 SPRING ST",
            "address_2": "SUITE 400",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209102735",
            "telephone_number": "301-495-3742",
            "fax_number": "301-495-3743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEA",
        "first_name": "DALLAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2015-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "MD",
            "license": "D59136",
            "primary": true
        },
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "DC",
            "license": "MD33523",
            "primary": false
        },
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "TX",
            "license": "L3375",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.