Leidenix PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

511 Issued in ND

Legal business name

LEIDENIX PC

Doing business as

Bis-Man Eyecare Associates

Practice address

1400 Skyline Blvd
Bismarck, ND 58503-1613

Phone

(701) 255-4117

Fax

(701) 255-4174

NPI assigned

Jul 26, 2007

Last updated

Oct 3, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melissa Mattson

Title

Manager

Phone

(701) 663-0012

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Bis-Man Eyecare Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Leidenix PC

  dba Bis-Man Eyecare Associates

  • Optometrist
  • Mandan, ND
  • NPI 1184057374

  O20060920000515

  Same enrollment
• Leidenix PC

  dba Bis-Man Eyecare Associates

  • Optometrist
  • Bismarck, ND
  • NPI 1669401527

  O20060920000515

  Same enrollment

Tax ID family

Bis-Man Eyecare Associates3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Leidenix PC

  dba Bis-Man Eyecare Associates

  • Optometrist
  • Mandan, ND
  • NPI 1184057374
  NPD tax ID
• Leidenix PC

  dba Bis-Man Eyecare Associates

  • Optometrist
  • Bismarck, ND
  • NPI 1669401527
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jason D Erhardt, O.D.

  • Optometrist
  • Bismarck, ND
  • NPI 1093088122
  NPD
• Cameron Thomas Deschamp, O.D.

  • Optometrist
  • Minot, ND
  • NPI 1962518779
  NPD (past)
• Taya Marie Patzman, OD

  • Optometrist
  • Bismarck, ND
  • NPI 1750345252
  NPD (past)

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1063602050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 OLD RED TRL NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585543052",
            "telephone_number": "701-663-0012",
            "fax_number": "701-663-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 SKYLINE BLVD",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585031613",
            "telephone_number": "701-255-4117",
            "fax_number": "701-255-4174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEIDENIX PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "MATTSON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "701-663-0012"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60631",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1461913",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bis-Man Eyecare Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bis-Man Eyecare Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rhonda Leet
• Jennifer Lefever, LCSW
• Andrea Lynn Leftwich
• Legacy Homecare LLC
• Legacy Medical LLC
• Leidenix PC (Bis-Man Eyecare Associates)
• Monte John Leidenix, M.D. F.A.C.S.
• Heather M. Leier, FNP-C
• Jennifer M Leier, FNP
• Makenna Jo Leier

• Optometrist in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Optometrist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.