Individual provider Active NPI

Richard J. Leidinger, M.D.

  • Urology Physician
  • Berlin, VT
National Provider Identifier
1073605994
Registry record updated Mar 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
042.0012561 Issued in VT
Practice address
286 Hospital Loop
Berlin, VT 05602-9523
Phone
(802) 371-4820
Fax
(802) 371-4855
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 013870 ME
Urology Physician 208800000X 042.0012561 VT Primary

Addresses

Primary practice location

286 Hospital Loop
Berlin, VT 05602-9523

Mailing address

PO Box 547
Barre, VT 05641-0547
Phone (802) 371-4820

Other identifiers 2

IdentifierTypeStateIssuer
1021260MedicaidVT
003108601OtherVTMEDICARE PIN LINKED TO VN3891

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20050725000816 ME Practitioner - Urology 4587691282 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Aroostook Medical CenterGroup PAC ID 1153233663, 117 clinicians

Practice addresses (Care Compare)

140 Academy St
Presque Isle, ME 04769-3102

146 Academy St
Presque Isle, ME 04769-3102

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as group
Quality
71.56
Promoting interoperability
96
Improvement activities
40
Cost
76.21

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013870MEMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Penobscot Bay Physicians & Associates CurrentSince Nov 12, 2018 Accepting new patients
The Aroostook Medical Center CurrentSince Sep 1, 2014 Accepting new patients
The Aroostook Medical Center CurrentSince Sep 1, 2014 Accepting new patients
Central Vermont Medical Center Inc Urology Past Accepting new patients

Locations

931 Union St
Fl 3
Bangor, ME 04401

140 Academy St
Ste 10
Presque Isle, ME 04769
Phone (207) 764-3734

140 Academy St
#10
Presque Isle, ME 04769
Phone (207) 764-3734

6 Glen Cove Dr
Rockport, ME 04856
Phone (207) 596-8000

3 Glen Cove Dr
#3
Rockport, ME 04856
Phone (207) 301-5400

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Northern Light Acute RehabilitationPresque Isle, ME, CCN 20T018 Hospital Corporate Director Sep 30, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 6

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1073605994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410547",
            "telephone_number": "802-371-4820",
            "fax_number": "802-371-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 HOSPITAL LOOP",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056029523",
            "telephone_number": "802-371-4820",
            "fax_number": "802-371-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIDINGER",
        "first_name": "RICHARD",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ME",
            "license": "013870",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VT",
            "license": "042.0012561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021260",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN LINKED TO VN3891",
            "identifier": "003108601",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, VT

Sources for this page

Verify at the official NPI Registry.