Mark Michael Leyngold, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

ME116419 Issued in FL

Practice address

3015 E Goldstone Dr # 130
Meridian, ID 83642-1549

Phone

(208) 900-4673

Fax

(208) 266-5033

NPI assigned

Mar 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Plastic and Reconstructive Surgery

Education

Florida State University College of Medicine, 2006

Medicare assignment

May accept Medicare assignment

Group practices

Leyngold Institute for Plastic Surgery PLLCGroup PAC ID 4789079948, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Leyngold Institute for Plastic Surgery PLLC

  dba Leyngold Institute for Plastic Surgery

  • Plastic and Reconstructive Surgery Physician
  • Meridian, ID
  • NPI 1972277895
  Medicare reassignment Care Compare group NPD
• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1063531929
  NPD (past)

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

• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1093839003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 E GOLDSTONE DR # 130",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421549",
            "telephone_number": "208-900-4673",
            "fax_number": "208-266-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 E GOLDSTONE DR # 130",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421549",
            "telephone_number": "208-900-4673",
            "fax_number": "208-266-5033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103003",
            "country_code": "US",
            "telephone_number": "352-265-7999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEYNGOLD",
        "first_name": "MARK",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME116419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008971400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "20024303",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Lewis
• Sara Nicole Lewis, NP
• Shaye Lewis, M.D.
• Leyngold Institute for Plastic Surgery PLLC (Leyngold Institute for Plastic Surgery)
• Ilya M Leyngold, MD
• LHSC LLC (Lighthouse Senior Care)
• Liang Wu MD LLC (Liang Wu MD)
• Lice Clinics of Boise
• Maddie Liddiard, LMSW
• Lifefill III, LLC

• Plastic Surgery Physician in Meridian, ID
• Providers in Meridian, ID by specialty
• Plastic Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.

Verify at the official NPI Registry.