Individual provider Active NPI

Benjamin Leishman, D.O.

  • Family Medicine Physician
  • Idaho Falls, ID
National Provider Identifier
1063862977
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O-1351 Issued in ID
Practice address
1582 Elk Creek Dr
Idaho Falls, ID 83404-8322
Phone
(208) 881-0227
NPI assigned
Jun 21, 2016
Last updated
Apr 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X O-1351 ID Primary
Sports Medicine (Family Medicine) Physician 207QS0010X O-1351 ID

Addresses

Primary practice location

1582 Elk Creek Dr
Idaho Falls, ID 83404-8322

Mailing address

1582 Elk Creek Dr
Idaho Falls, ID 83404-8322
Phone (208) 881-0227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20200707002607 ID Practitioner - Osteopathic Manipulative Medicine 3375839517 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altitude Sport and Spine PLLCGroup PAC ID 4486129384, 2 clinicians

Practice addresses (Care Compare)

1582 Elk Creek Dr
Idaho Falls, ID 83404-8322
Phone (208) 213-5256

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Pocatello PLLC Current Accepting new patients
Community Care West Side LLC Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
CC Pocatello LLC Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Mountain View Hospital LLC CurrentSince Jul 1, 2020 Accepting new patients
Community Care Family Medicine Current Accepting new patients

Locations

1582 Elk Creek Dr
Idaho Falls, ID 83404
Phone (208) 213-5256

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

2725 Channing Way
Idaho Falls, ID 83404
Phone (208) 525-8448

765 S Utah Ave
Idaho Falls, ID 83402
Phone (208) 525-2600

1595 Yellowstone Ave
Pocatello, ID 83201
Phone (208) 233-0032

167 E 1st S
Rigby, ID 83442
Phone (208) 745-8747

Interoperability endpoints

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

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1063862977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1582 ELK CREEK DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048322",
            "telephone_number": "208-881-0227",
            "fax_number": "877-682-5081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1582 ELK CREEK DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048322",
            "telephone_number": "208-881-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEISHMAN",
        "first_name": "BENJAMIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-21",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-1351",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "ID",
            "license": "O-1351",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.