Active NPI
Leelan Nicholas Michael Bhagwandeen, PSYD
- Clinical Neuropsychologist
- Port St Lucie, FL
National Provider Identifier
1093661159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PY13112
- Practice address
- 2100 SE Hillmoor Dr Ste 201
Port St Lucie, FL 34952-8057 - Phone
- (772) 278-5508
- NPI assigned
- Mar 10, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PY13112 | FL | Primary |
Addresses
Primary practice location
2100 SE Hillmoor Dr Ste 201
Port St Lucie, FL 34952-8057
Mailing address
2938 Janet PL
Hammond, IN 46323-1137
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2100 SE Hillmoor Dr
201Port
Port Saint Lucie, FL 34952-8057
2938 Janet PL
Hammond, IN 46323-1137
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY13112 | FL | MD | Clinical Neuropsychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Treasure Coast Neuropsychology PA | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Port St Lucie, FL
- NPI 1689454613
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773100800000",
"number": "1093661159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2938 JANET PL",
"city": "HAMMOND",
"state": "IN",
"postal_code": "463231137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 SE HILLMOOR DR STE 201",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349528057",
"telephone_number": "772-278-5508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BHAGWANDEEN",
"first_name": "LEELAN",
"middle_name": "NICHOLAS MICHAEL",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-03-10",
"last_updated": "2026-03-10",
"certification_date": "2026-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "FL",
"license": "PY13112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.