Glen E Leer, D.O.

Individual provider Active NPI Family Medicine Physician · Arcadia, IN

NPI 1063505667 · NPPES record last updated May 21, 2019

Key facts

NPI
1063505667
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
02001252A (IN)
Practice address
204 W. Main Street
Arcadia, IN 46030
Phone
(317) 984-8811
Fax
(888) 634-3182
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
Yes

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

204 W Main St
Arcadia, IN 46030-0383
Phone (317) 984-8811

Hospital & facility affiliations

  • Indiana University Health Tipton Hospital Inc Hospital · Tipton, IN · CCN 151311
  • Riverview Health Hospital · Noblesville, IN · CCN 150059
  • Ascension St Vincent Mercy Hospital · Elwood, IN · CCN 151308
  • Community Howard Regional Health Inc. Hospital · Kokomo, IN · CCN 150007

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20051121000616 IN Practitioner - Family Practice 5193744076 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02001252AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Family Medicine, LLC Family Medicine Current
since Aug 30, 1999
Accepting new patients
Major Hospital Past Accepting new patients

Locations

204 W Main St
Arcadia, IN 46030
Phone (317) 984-8811

204 W Main St
#383
Arcadia, IN 46030

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4695/brand/5/csg/1/fhir/r4
  • Direct secure messaging: lakeviewfamilymedicine.glenleer@137717.advancedmd-direct.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02001252A IN Yes

Addresses

Primary practice location

204 W. Main Street
Arcadia, IN 46030

Mailing address

PO Box 383
Arcadia, IN 46030-0383
Phone (317) 984-8811

Other identifiers

IdentifierTypeStateIssuer
4909800001OtherINMEDICARE DMEPOS
100319180BMedicaidIN
1343052OtherINFIRST HEALTH

Other providers in Arcadia, IN

All providers in Arcadia, IN · Family Medicine Physician in Indiana

Sources for this page

Verify at the official NPI Registry.